| 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 |