| NPI | 1053648774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDAL ANTHONY GOMEZ Managing Member 225-683-4144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: LA 156) |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2009-11-17 |