| NPI | 1457577892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA T BRANDON Owner 225-925-5003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: LA 11299) |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: LA 11297) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |