| NPI | 1275957979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA GANDOLFO Owner 985-687-5226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 2753) |
| Enumeration Date | 2014-02-17 |
| Last Update Date | 2014-02-17 |