| NPI | 1851834527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN WILLIAMS Administrator / Program Director 318-771-9806 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: LA 2203782947) |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2016-11-29 |