| NPI | 1508410648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN DANETTE WALLS RN/Administrator 501-313-2961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WA2000X Registered Nurse, Administrator |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2020-09-18 |