NPI | 1154790541 |
---|---|
Entity Type | Organization |
Authorized Contact | CLAUDE JOSEPH SMITH Owner 318-791-2116 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: LA 3205100102015) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA 3205100102015) |
Enumeration Date | 2015-09-16 |
Last Update Date | 2015-09-16 |