| NPI | 1063609204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA DENISE CARTER Pastor 225-346-5225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: LA SIL 12514) |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2007-10-02 |