| NPI | 1699516534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHUNTA SHARLAN PRINGLE Admin. Credentialing Coordinator 318-278-5964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2024-06-04 |
| Last Update Date | 2024-06-04 |