EBONY LATREACE CHARLESTON

CONWAY, AR
NPI1508371865
Other NameEBONY L FORD
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2017-12-08
Last Update Date2020-01-23
Business Address
EBONY LATREACE CHARLESTON QBHP
3240 STERMER ROAD
CONWAY, AR 72034
Phone number: 501-327-1701
Mailing Address
EBONY LATREACE CHARLESTON QBHP
110 SKYLINE DR
RUSSELLVILLE, AR 72801-3362
Phone number: 479-967-5570
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