| NPI | 1528555018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI BIERBAUM Clinical Director 318-562-6616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2021-06-03 |