| NPI | 1932962917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMILLE JOHNSON Owner 801-603-9671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-02-02 |
| Last Update Date | 2024-02-05 |