| NPI | 1790675908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL PETERSON Owner 501-260-7324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-07-08 |
| Last Update Date | 2025-07-08 |