| NPI | 1104459064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP SEAN WENDELL CEO 337-678-3611 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2020-12-24 |