| NPI | 1003802745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA L COWART Office Manager 225-771-1510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: LA 014945) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2008-12-08 |