| NPI | 1124341425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT LEJEUNE Clinical Supervisor 318-335-3578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 220) |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2015-12-29 |