| NPI | 1104314384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MAXIE Owner 318-573-3942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251B00000X Case Management | |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2022-05-31 |