| NPI | 1982947347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN PACE Executive Director 435-673-6111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: UT 20523) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: UT 20523) |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children (Licence: UT 20523) | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2015-06-24 |