| NPI | 1003371626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROAN JORDAN FLENNIKEN Licensed Professional Councelor 318-455-6008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-02-07 |
| Last Update Date | 2019-02-07 |