| NPI | 1154750644 |
|---|---|
| Doing Business As | FPHSA MANDEVILLE CLINIC |
| Entity Type | Organization |
| Authorized Contact | MELANIE WATKINS Executive Director 985-543-4333 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 119) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2015-02-16 |