| NPI | 1356908214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAIMEKA HAGGANS CEO 870-455-3004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251S00000X |
| 253Z00000X In Home Supportive Care | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2021-11-03 |