| NPI | 1639791411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY TUCKER VP Of Operations 870-932-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2020-11-30 |