| NPI | 1780879361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNY CHARLES HARRIS C. E. O. 870-246-8212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: AR 302R00000X) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2007-09-07 |