NPI | 1457713224 |
---|---|
Entity Type | Organization |
Authorized Contact | KNAKITA BAILEY Practice Manager 318-623-5839 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA MD201241) |
Enumeration Date | 2016-03-22 |
Last Update Date | 2016-03-22 |