| NPI | 1851886352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE M LEWIS Lpn 501-686-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AR L049916) |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: AR LO49916) |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2018-07-06 |