| NPI | 1023855467 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | VALERIE SELVAGE Administrator 225-443-1225 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| 101YP2500X Counselor, Professional | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2024-07-12 | 
| Last Update Date | 2024-07-12 |