| NPI | 1629491717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAITLIN FITCH Human Resource Administrator 501-329-5459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2014-01-27 |
| Last Update Date | 2014-01-27 |