| NPI | 1063648921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK J CULLEN Manager 337-785-8003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2009-06-05 |