| 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 |