| NPI | 1275240228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOHNSON Program Administrator/Owner 337-707-3872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| 251B00000X Case Management | |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2023-06-05 |