NPI | 1063019156 |
---|---|
Entity Type | Organization |
Authorized Contact | ABIGAIL JOHNSON CEO 318-379-4488 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2020-10-02 |
Last Update Date | 2020-10-02 |