| NPI | 1689916876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE DAVIS Mhc Program Manager 318-371-3001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 726011595) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2013-03-26 |