| NPI | 1184987265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGRID DIANNE CANNELLA Owner/Operator 318-792-3331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2012-06-22 |