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KA Legacy INC

Manila, AR Unclaimed

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NPI Number *

Email *

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Organization / Practice Name *

Contact First Name *

Contact Last Name *

Business Phone

Street Address

Address 2 / Suite

City

State

ZIP Code

Primary Specialty

License Number

NPI

1174396980
Name

KA Legacy INC
Account Contact

Tonya Grissom-tatroe
Address

103 W FLEEMAN, MANILA, AR, 72442
Phone

870-919-6585
Specialties

Community/behavioral Health Clinic/center, Mental Health (including Community Mental Health Center) Counselor, Professional
NPPES Last Updated

2023-11-02

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