| NPI | 1194176792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUAONE ANDERS Owner 318-732-8941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2023-06-22 |