| NPI | 1144575531 |
|---|---|
| Other Name | MOSS SIDE COUNSELING |
| Entity Type | Organization |
| Authorized Contact | DEBORAH LYNETTE THOMAS Owner 225-324-8075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: LA 1079) |
| Additional Taxonomies | 251B00000X Case Management (Licence: LA 00016582) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2012-07-20 |