| NPI | 1447396247 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | ASHLEY LYNN EUBANKS Billing 318-410-1062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2016-04-14 |