| NPI | 1568461887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA YABLONSKI Credentialing Specialist 479-725-5140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2022-07-21 |