| NPI | 1972133783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY JENSON Manager 801-556-1977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine Addiction Medicine |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 163WA0400X Registered Nurse Addiction (Substance Use Disorder) | |
| 2084A0401X Psychiatry & Neurology Addiction Medicine | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2020-01-21 |
| Last Update Date | 2024-10-14 |