| NPI | 1710231931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA DAHLGREN Medical Staff Coordinator 479-587-5901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 284300000X Special Hospital (Licence: MD 03017) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2012-11-09 |