| NPI | 1710242805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY JAMES WILLIAMS Owner 318-219-9508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 1692) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2012-07-05 |