| NPI | 1326573973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE MCDANIELS Administrator 318-636-0391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2018-01-08 |