| NPI | 1992148779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERRETT BONNELLA Lcsw/Inte RN Supervisor 801-428-3241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2013-04-11 |