| NPI | 1831708718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE MARIE JONES Administrator 318-614-9043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 172A00000X Driver | |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2020-07-27 |