| NPI | 1154672814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA S DAVIS Director 225-200-5278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2012-09-20 |