| NPI | 1730803859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETATIA R VANCE Administrator 318-572-6606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 385H00000X Respite Care |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2025-06-10 |