| NPI | 1376805440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWANGI CARILESS RICHARDSON-ALSTON Clinical Social Worker 504-239-0989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 7358) |
| Additional Taxonomies | 251S00000X (Licence: LA 7358) |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: LA 7358) | |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2012-06-13 |