| NPI | 1881065209 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | CHRISTINA SMITH Mhs 318-550-1215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2015-10-12 |