| NPI | 1720096027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE ACKERSON CEO 870-448-5733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2019-01-25 |