| NPI | 1649469479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J. LOFTON Authorized Official 318-308-1880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 55444) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 969) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: LA 01007) | |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2023-09-06 |