| NPI | 1336694298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDDIE GENE CONERLY Owner 504-246-9860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2023-06-16 |