| NPI | 1477216059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE DOUGLAS DRAIN COO 479-595-2555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2021-10-20 |