| NPI | 1679914261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD KELLY ALTMAN Regional Director 479-586-3101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL PS 50266) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2013-07-11 |