| NPI | 1013932904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SURESH K DONEPUDI Owner 318-688-5416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-08-08 |