| NPI | 1205618535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA P BOYLE Chief Operating Officer 501-348-2210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-10-20 |
| Last Update Date | 2024-01-09 |