| NPI | 1700228558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERISH E BILLINGSLEY Administrative Director 870-247-5222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: AR P1211108) |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2021-01-13 |