| NPI | 1003920414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODIE LINCOLN ROBERTS Director 318-561-2010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2020-08-22 |