| NPI | 1467824946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONYA CHARLES Ofiice Manager 337-353-2129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2015-10-23 |