| NPI | 1871299370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAY RUSSELL Executive Director 318-805-4775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2023-02-06 |