| NPI | 1891817151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY LEE AUBREY Administrator 318-861-4357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 101YM0800X) |
| Enumeration Date | 2007-04-05 |
| Last Update Date | 2008-06-26 |