| NPI | 1427936640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTIS AUTREY Owner 225-772-2314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2025-08-25 |
| Last Update Date | 2025-08-25 |