| NPI | 1124896600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRISCILLA TRUDELL Health Information Director 501-303-3115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-12-14 |
| Last Update Date | 2023-12-14 |