| NPI | 1760755888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE MARY THOMPSON Therapist 501-551-5980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AR 2577-C) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: AR 2577-C) |
| 302R00000X Health Maintenance Organization (Licence: AR 2577-C) | |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2012-04-12 |