| NPI | 1093530370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARNITTA DEMMING Owner 318-564-2330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-11-20 |
| Last Update Date | 2024-11-20 |