| NPI | 1467687475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERICK D WATKINS Owner 318-949-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2009-10-13 |