| NPI | 1548398910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE M DEROECK Psychologist 870-972-4770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |