| NPI | 1619704707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA DOUGLAS Owner 318-224-9088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-09-13 |
| Last Update Date | 2025-06-29 |