| NPI | 1669907408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONETTE WILLIAMS Director 501-612-4406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: AR 300155) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2017-05-01 |