| NPI | 1639978950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSIE L. RICE Administrator 501-786-1759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2025-03-10 |
| Last Update Date | 2025-03-11 |