| NPI | 1194182774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALENCIA DEMUCHEST Owner/Administrator 337-514-2101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: LA 2203782856) |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2023-06-22 |