| NPI | 1154503803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHTON SPEARS Billing Agent 225-505-3285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 12763) |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2007-12-04 |