| NPI | 1407326366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM BROWN Director Of Compliance 870-243-7219 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2024-03-11 |