| NPI | 1164636957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY A SCOTT Owner 318-255-9105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 7184) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |