| NPI | 1760632095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMI HEFLIN Clinical Director 318-322-0037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 2308) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2008-09-23 |