| NPI | 1639256522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLIN MATHIS Owner/Director 318-255-0010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: LA in process) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |