| NPI | 1619204492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA HOLMES Administrator 318-614-5445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2009-11-16 |
| Last Update Date | 2025-08-01 |