| NPI | 1376780783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN D OSBORN Manager 985-373-4818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 251S00000X) |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |