| NPI | 1043472608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELVIN HORNE Owner 318-323-0463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2023-07-07 |