| NPI | 1043684343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DETRA BLACKWELL Business Manager 504-944-0453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2023-06-27 |