| NPI | 1053801548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARASA ANDERSON Director/Owner 985-785-4451 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 2203783821) |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2018-05-10 |