| NPI | 1477036390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACAHRRA JOHNSON Office Manager 318-226-9944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 11821391427) |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2018-09-07 |