| NPI | 1316271877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDY SIBLEY President / Practitioner 318-868-5008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: LA 830) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: LA 2841) |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2009-09-30 |