| NPI | 1942663778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHLAN RAYMO Executive Director 318-209-0204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 15398) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2016-03-30 |