| NPI | 1265222012 |
|---|---|
| Other Name | L |
| Entity Type | Organization |
| Authorized Contact | LAURA L LARUE Pmhnp/ Fnp 270-317-0271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-05-07 |
| Last Update Date | 2025-05-07 |