| NPI | 1285241422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONEE RESHAE MCKEEL Owner 318-801-9331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2024-01-17 |