| NPI | 1770873499 |
|---|---|
| Doing Business As | CLARKSVILLE BRANCH - PHOENIX CENTER |
| Entity Type | Organization |
| Authorized Contact | ROLANDO N GARCIA CFO 501-315-3344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2011-04-14 |