| NPI | 1396095741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA BAKER President 870-336-7526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: AR P1112094) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2012-09-13 |