| NPI | 1578119996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN HOLLINS COO 318-230-5794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 207RP1001X Internal Medicine Pulmonary Disease | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2023-05-01 |