| NPI | 1174971675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY M MARTIN Sole Member 337-515-1762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 8657) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2017-01-18 |