| NPI | 1871990358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROOPER TOLBERT Director 501-765-2911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 305R00000X Preferred Provider Organization |
| 251B00000X Case Management | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251B00000X Case Management | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2015-10-26 |