| NPI | 1225202179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE FOUTCH Site Director 479-484-7782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable (Licence: AR 105) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2012-09-05 |