| NPI | 1114247863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANNY TINKER Owner 870-886-1333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2010-06-04 |