| NPI | 1366941155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW ALEXANDER DECLOUET Nurse Practitioner 337-484-1415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: LA 1518342310) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2018-02-07 |