| NPI | 1982972964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN ROGER BAILEY Program Director 435-262-0891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2011-12-06 |