| NPI | 1790279131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORLANDO CARTER CEO 731-935-9267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP1600X Counselor Pastoral | |
| 163WC0400X Registered Nurse Case Management | |
| 163WC1500X Registered Nurse Community Health | |
| 207QA0401X Family Medicine Addiction Medicine | |
| 261QP2300X Clinic/Center Primary Care | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2024-04-26 |