| NPI | 1295965101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT L MATHERNE CEO/Adminsitrator 985-223-4009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: LA 431) |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2009-07-27 |