| NPI | 1043536063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY J GREGORY Office Manager 870-222-4544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: AR 01923) |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2010-04-15 |