| NPI | 1861156507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMERA TAYLOR CAC/Mhp 318-914-2632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2023-09-05 |