| NPI | 1326875931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATELYN MELANCON Program Coordinator 225-468-6287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| Enumeration Date | 2024-09-17 |
| Last Update Date | 2025-03-13 |