| NPI | 1083986210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET L MOORE Administrator 318-574-3146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: LA 9950) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-02-03 |