| NPI | 1417428566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVONNE DOOLEY COO 501-655-6059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2022-11-02 |