| NPI | 1477119105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONYA YORK Administrative Assistant 870-856-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2019-05-17 |
| Last Update Date | 2020-11-06 |