| NPI | 1932119187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON SHERMAN CEO 870-520-5014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2024-01-05 |