| NPI | 1184292708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTELE ANGELA BUTLER Owner/ Operator 225-380-5191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-06-11 |
| Last Update Date | 2021-07-20 |