| NPI | 1780160390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE LAMB Director 318-651-0086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 2203783817) |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-07-17 |