| NPI | 1750807533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY JO BURT Owner 870-403-4879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AR P1702237) |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2017-08-14 |