| NPI | 1952505117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER THOMAS Executive Director 801-412-6920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 122300000X Dentist | |
| 207Q00000X Family Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2023-10-30 |