| 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 |