NPI | 1750159489 |
---|---|
Entity Type | Organization |
Authorized Contact | SHAWANDA MARTIN Owner 318-751-3990 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2023-12-12 |
Last Update Date | 2023-12-12 |