NPI | 1871813717 |
---|---|
Entity Type | Organization |
Authorized Contact | KATRINA OVALETTE BODEN Owner 318-681-9935 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 251S00000X |
Enumeration Date | 2010-06-02 |
Last Update Date | 2023-06-21 |