NPI | 1154549285 |
---|---|
Entity Type | Organization |
Authorized Contact | KYLE JACOB CFO 318-747-8895 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 251S00000X |
Enumeration Date | 2007-04-23 |
Last Update Date | 2023-07-24 |