| NPI | 1245603331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLIN RICHARDSON Administrator 318-512-4997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2015-11-11 |
| Last Update Date | 2023-06-21 |