| NPI | 1306512686 |
|---|---|
| Doing Business As | RUSTIC ROOTS COUNSELING CENTER, LLC |
| Entity Type | Organization |
| Authorized Contact | SHEREVA S LEWIS Owner 337-254-2629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2021-08-18 |