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1114227717
JONATHAN GAILES
TEXARKANA, AR
NPI
1114227717
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2010-10-28
Last Update Date
2010-10-28
Business Address
-- JONATHAN GAILES MHPP
701 ARKANSAS BLVD
TEXARKANA, AR 71854-2105
Phone number: 870-772-5028
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Mailing Address
-- JONATHAN GAILES MHPP
3352 N FUTRALL DR
FAYETTEVILLE, AR 72703-4057
Phone number: 479-521-5868
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