NPI | 1023497062 |
---|---|
Entity Type | Organization |
Authorized Contact | MARKUS BOSLEY Administrator 318-450-4911 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
324500000X Substance Abuse Rehabilitation Facility | |
Enumeration Date | 2015-05-22 |
Last Update Date | 2025-02-03 |