| NPI | 1821115528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE BRIAN Operating Manager 318-423-4150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: TN L000000008511) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2012-02-02 |