| NPI | 1104168566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTAL CHAMBERS Director 318-626-7143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA 4174) |
| 251S00000X (Licence: LA BH0012249) | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2023-06-23 |