| NPI | 1700689197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA PAGE Director 501-918-0138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2025-03-31 |
| Last Update Date | 2026-02-02 |