| NPI | 1780367052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA CARROLL Human Resource 501-414-6753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist Group Psychotherapy |
| Additional Taxonomies | 104100000X Social Worker |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2023-08-11 |
| Last Update Date | 2024-09-02 |