| NPI | 1275077257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAKIA SHANA THOMAS Owner 318-207-0267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 9568) |
| Enumeration Date | 2016-12-11 |
| Last Update Date | 2016-12-11 |