| NPI | 1437393162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP ISHERWOOD Medical Director 318-742-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2009-06-04 |