| NPI | 1255834081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNADETTE STANFORD Owner 501-270-9503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AR P1412107) |
| Enumeration Date | 2018-03-18 |
| Last Update Date | 2023-09-27 |