| NPI | 1659801769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY LUCAS LEWALLEN CEO 870-926-5710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2017-09-26 |