| NPI | 1063967875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BANTU D. GROSS Mental Health Professional 504-940-8249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2016-08-22 |