| NPI | 1790082311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIAN F GREEN Owner/Director 870-235-1112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AR 218949578) |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2011-03-21 |