NPI | 1851891865 |
---|---|
Entity Type | Organization |
Authorized Contact | SHANELL TAYLOR Owner 318-791-7872 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 2203783795) |
Enumeration Date | 2018-02-15 |
Last Update Date | 2018-03-29 |