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 |