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 |