| 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 | |
| Enumeration Date | 2024-07-12 |
| Last Update Date | 2024-07-12 |