NPI | 1306217062 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHANIE ROACH Owner 318-570-5400 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 251S00000X |
324500000X Substance Abuse Rehabilitation Facility | |
3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
Enumeration Date | 2015-10-07 |
Last Update Date | 2023-07-18 |