| NPI | 1487232336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRIEL JONES Owner 318-655-4785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2024-02-05 |