| NPI | 1376936658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRBY SANDLIN Owner 337-654-6634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: TX 66357) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: TX 201550) |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2015-03-11 |