| NPI | 1740406339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRI A EVANS Mr Dd Regional Administrator 318-641-2003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 6653) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-08-22 |