| NPI | 1043033277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHALONDA WALLACE GOLDEN Licensed Clinical Social Worker 225-202-3830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-11-05 |
| Last Update Date | 2024-11-05 |