| NPI | 1992934442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AKEE L JACKSON Administrator / Director 318-584-1451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: LA 4322) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: LA 5242) |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2009-07-06 |