NPI | 1417352428 |
---|---|
Entity Type | Organization |
Authorized Contact | SIBAL HOLT Administrator 318-619-2992 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: LA 2203782155) |
Enumeration Date | 2014-11-03 |
Last Update Date | 2014-11-03 |