NPI | 1326685603 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMIKA MASON Billing And Credentialing Manager 337-308-0974 |
Organization Subpart ? | No |
Primary Taxonomy | 347E00000X Transportation Broker |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
261QM0850X Clinic/Center, Adult Mental Health | |
Enumeration Date | 2019-12-05 |
Last Update Date | 2019-12-05 |