| NPI | 1730543869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA BAXTER CEO 318-564-6197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: LA HC0007512) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA HC0007512) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-04-05 |