| NPI | 1760791099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHLAN SHEANTRELL RAYMO CEO 318-648-2580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA ADHC 5062) |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2010-10-05 |