| NPI | 1326717745 |
|---|---|
| Doing Business As | MAINLINE UAM BEHAVIORAL HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | GARY ALLAN NICHOLS CEO 870-942-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2024-09-18 |