| NPI | 1972975225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY HARRIS Owner 318-450-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2023-06-22 |