| NPI | 1073015574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKYSHA STARKS-SAMPSON Owner 318-224-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QR0800X Clinic/Center, Recovery Care | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2023-10-31 |