| NPI | 1306172127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIHARIKA S. SHAH Health Services Administrator 870-630-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2009-10-29 |