| NPI | 1033738562 |
|---|---|
| Other Name | NA |
| Entity Type | Organization |
| Authorized Contact | JALIAH PABON Administrator 225-810-3885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2023-07-18 |