| NPI | 1124201793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN ASHCRAFT PUCKETT Clinical Social Worker 318-641-0008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 3066) |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2007-12-06 |