| NPI | 1922988906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KALETHIA BUSH Office Administrator 318-914-6744 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X Community/Behavioral Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2025-09-02 |
| Last Update Date | 2025-09-02 |