| NPI | 1154448819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J POLITTE Federal Funds Administrator 501-682-1264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |