| NPI | 1194950956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA LANISE CLEMONS Administrator 225-930-0051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 1371548) |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2009-05-22 |