| NPI | 1518677632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAVARIUS GASTON Chief Executive Officer 501-613-8117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2022-11-30 |
| Last Update Date | 2022-11-30 |