| NPI | 1508310806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA WILLIAMS Clinical Director 318-681-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: LA 5599) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 5599) |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2016-08-04 |