| NPI | 1821299645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIQUINTA J PIPES Office Manager 870-534-7860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: AR 2328) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: AR C5909) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2020-08-22 |