Provider First Line Business Practice Location Address:
106 CYPRESS AVE
Provider Second Line Business Practice Location Address:
EAST ARKANSAS YOUTH SERVICES
Provider Business Practice Location Address City Name:
MARION
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-739-4219
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/16/2006