NPI | 1881055507 |
---|---|
Entity Type | Organization |
Authorized Contact | AYNSLEY LUCKETT DOYLE Owner 318-880-8711 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 251S00000X |
Enumeration Date | 2016-03-08 |
Last Update Date | 2023-06-28 |