| NPI | 1891463998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA WOODS Operational Manager 870-450-9846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2021-09-02 |