| NPI | 1154629277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS A SMALL Owner 318-228-8801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: LA 5785118-001) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2023-07-12 |