| NPI | 1194188912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA R HODGES Owner 870-935-4102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AR P1508087) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2016-03-30 |