| NPI | 1699828657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER LLOYD WINSLOW Owner 870-508-2644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AR E 4224) |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2008-05-15 |