| NPI | 1982794962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI HILBUN Business Manager 318-728-2970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: LA 273) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2012-03-05 |