| NPI | 1447055074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL X SU CEO 318-918-0525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2025-02-18 |
| Last Update Date | 2025-05-14 |