NPI | 1326690595 |
---|---|
Entity Type | Organization |
Authorized Contact | TRACY TERWILLIGER CEO 501-463-4627 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2019-07-09 |
Last Update Date | 2021-01-05 |