| NPI | 1992823249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS DOSS Registered Agent 435-669-8970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2008-07-24 |