| NPI | 1124661855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN COLLIER CEO 870-347-3204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2020-10-09 |