| NPI | 1598180275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH HALL Executive Administrator 318-512-2505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2014-03-04 |