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 |