| NPI | 1265658934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID E SMITH Executive Director 318-281-4889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: LA SIL 8083) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-08-22 |