| NPI | 1497121214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH R ORANGE Owner 318-791-7170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 4149) |
| Enumeration Date | 2015-08-16 |
| Last Update Date | 2015-08-16 |