| NPI | 1669742011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL BROUD HESTER Owner 870-219-1407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: AR 81-4P) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |