NPI | 1659403921 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT LAYNE BONVILLAIN Owner 318-425-3333 |
Organization Subpart ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 316) |
Enumeration Date | 2007-03-12 |
Last Update Date | 2020-08-22 |