| NPI | 1629808092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARKITA DISMUKE Owner/Manager 318-503-8553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-08-01 |
| Last Update Date | 2024-08-01 |