| NPI | 1447017355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH KENNETH THIBEAUX CEO 225-810-6134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QH0100X Clinic/Center, Health Services | |
| 261Q00000X Clinic/Center | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QF0050X Clinic/Center, Family Planning, Non-Surgical | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2024-03-06 |
| Last Update Date | 2024-03-06 |