| NPI | 1417518523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL RAY GRACE Owner/Practioner 870-926-6280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2019-06-28 |