NPI | 1316665466 |
---|---|
Entity Type | Organization |
Authorized Contact | CLEVELAND MOUTON President 318-820-6941 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
Enumeration Date | 2022-08-16 |
Last Update Date | 2024-01-25 |