| NPI | 1760763452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAY DIANE CAESAR Director 318-730-1061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 6179) |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2011-09-08 |