NPI | 1477070324 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMIE HARRELL Owner 318-208-8908 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 251S00000X |
Enumeration Date | 2017-08-22 |
Last Update Date | 2024-02-13 |