| NPI | 1326284266 |
|---|---|
| Other Name | MARIANNA OUTPATIENT PROGRAM |
| Entity Type | Organization |
| Authorized Contact | SHELLA POUNDS Compliance Officer 870-735-0300 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X (Licence: AR 171504526) |
| Enumeration Date | 2008-12-24 |
| Last Update Date | 2013-08-12 |