| NPI | 1962999359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRANT K GORDY Executive Director 501-319-7074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2024-05-07 |