| NPI | 1326594789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KALA JENKINS Manager 318-704-6041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 5899) |
| Additional Taxonomies | 251S00000X (Licence: LA 5899) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2016-11-01 |