| NPI | 1932641511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEITRA L FANT Therapist/ Vice President 318-791-0022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2016-11-14 |