| NPI | 1326717745 |
|---|---|
| Doing Business As | MAINLINE UAM BEHAVIORAL HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | GARY ALLAN NICHOLS CEO 870-538-5414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2021-10-26 |