| NPI | 1508079831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRIETTA WILSON Director 870-572-3417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 347B00000X Bus | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-08-22 |