| NPI | 1417776279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP CORY PRYOR Vice President 318-347-9978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-10-08 |
| Last Update Date | 2024-10-08 |