| NPI | 1629591086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY BEENE Lpc 479-549-5646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OR c4478) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2017-07-18 |