| NPI | 1245854991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISON KNACK Owner 479-841-1814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2020-05-28 |