NPI | 1407277817 |
---|---|
Entity Type | Organization |
Authorized Contact | MERIAN RENATA CARTER Owner 225-278-6607 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 3687) |
Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: LA 243896) |
Enumeration Date | 2014-01-02 |
Last Update Date | 2014-01-02 |