| NPI | 1073980520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKEY D. EVANS CEO 318-424-8735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2023-06-21 |