| NPI | 1245746841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA J. WATSON Owner 985-214-9079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-12-18 |
| Last Update Date | 2021-11-11 |