NPI | 1972313708 |
---|---|
Entity Type | Organization |
Authorized Contact | NANCY KELLEY Owner 318-331-0184 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2025-01-13 |
Last Update Date | 2025-01-13 |