| NPI | 1649733445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORLANDO CARTER CEO 731-935-9267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 2084A0401X Psychiatry & Neurology Addiction Medicine | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2024-04-26 |