| NPI | 1003308735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LAMONT LAXTON Director 225-300-8788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 6522) |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2020-03-30 |