| NPI | 1538373931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRIETTA WILSON Administrator 870-572-4124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: AR 461) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |