| NPI | 1447723143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BYNUM Administrative Manager 479-242-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2019-12-31 |