| NPI | 1518218668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT W BEARD Chief Financial Officer 870-735-3842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2020-11-18 |