| NPI | 1780058883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT TERRY Director Of Business Operations 318-670-8898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2015-11-30 |