| NPI | 1245588292 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | PAULA ESSMEIR Office Manager 318-737-7407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 3592) |
| Enumeration Date | 2012-08-23 |
| Last Update Date | 2012-08-23 |