| NPI | 1871599613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT WILLIAMS BEARD Chief Financial Officer 870-733-6303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2020-11-18 |