| NPI | 1952943284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYCIA E JURGELA Manager 801-678-3317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2024-02-02 |