| NPI | 1649381120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BUNCH Credentialing Director 479-725-5115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2026-03-19 |