| NPI | 1891152088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE FRANK Owner 479-310-0264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AR 16-23P) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: AR 16-23P) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: AR P1403037) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: AR 16-23P) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: AR P1403037) | |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2017-05-18 |