| NPI | 1013152180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA DEUTER Owner 870-974-9114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: AR I08IN178) |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2019-08-06 |