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 |