| NPI | 1164144812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ACACIA LYNETTE JOHNSON Therapist/Owner 870-204-5640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2022-09-22 |