| NPI | 1073135059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LABRENDA THOMAS Clinical Therapist/Social Worker 501-837-4526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2020-05-12 |