| NPI | 1275093841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMMY BROWN Owner 225-335-2240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2020-10-28 |