| NPI | 1497150940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN DENEICE AUGURSON Administration 318-235-9203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2014-10-27 |