| NPI | 1558770867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONIA FREEMAN COO 318-239-2325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2023-06-16 |