| NPI | 1609469543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEAL ANGRUM Chief Executive Officer 318-381-8584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-02-11 |
| Last Update Date | 2021-02-11 |