| NPI | 1972010106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANFORD JAMES GRAY Therapist/Owner 870-351-5020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2019-03-10 |