| NPI | 1417123258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY D. GREATHOUSE Staff Nurse 870-216-2512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: AR L29493) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2008-05-01 |