| NPI | 1467980037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PASSION LACOLE TAYLOR PAYNE Program Director 318-792-8448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2017-05-26 |