| NPI | 1104289453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY FOSTER Psr Specialist 318-323-9995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2016-04-04 |