NPI | 1043557275 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL DAN GAINES Director 225-636-2638 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 1656) |
Enumeration Date | 2013-01-08 |
Last Update Date | 2016-09-26 |