| NPI | 1578948055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHONTIA LATOYIA GRAY Owner/Manager 318-789-4272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2015-09-12 |