| NPI | 1992885180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLON DREW BLACK CFO 501-379-4249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 251S00000X | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2019-02-13 |