| NPI | 1427137074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW ST. AMANT Owner/Operator 318-675-0804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: LA 1151254) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2023-06-19 |