| NPI | 1801106638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA KAYE RICKS Rn3 318-283-0817 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: LA 101) |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2010-10-14 |