| NPI | 1699964148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIAN WILLIAMS Director 318-325-8048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2023-03-24 |