NPI | 1922634955 |
---|---|
Entity Type | Organization |
Authorized Contact | DESIREE EARLE Owner/Operator 318-453-6897 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2020-03-22 |
Last Update Date | 2020-03-22 |