| NPI | 1831957828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY KELLEY Office Manager 318-855-4509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-03-13 |
| Last Update Date | 2024-03-13 |