| NPI | 1528478039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TED SMITH Director 318-641-3717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2014-05-06 |