| NPI | 1649944117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA T DUPREE Office Manager 318-716-9085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 261QR0800X Clinic/Center, Recovery Care | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2021-08-06 |
| Last Update Date | 2022-03-10 |