| NPI | 1396036018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY HANEY Office Manager 870-569-4920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: AR 3708) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2011-04-28 |