| NPI | 1194009993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDELL FORNEA Owner / President 985-735-9448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2023-06-19 |