| NPI | 1558804740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VONETTA FAYE COOK Mental Health Professionsal 318-402-7789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: LA 251S00000X) |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2016-11-21 |