| NPI | 1255603064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP H WILLIAMSON Board Chairman 318-617-0376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 385) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2012-02-08 |