| NPI | 1366011884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW ALEXANDER DECLOUET Owner 337-280-0441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult |
| Enumeration Date | 2021-06-19 |
| Last Update Date | 2023-04-18 |