| NPI | 1528808953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ED G MURY Compliance Officer 337-704-1569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-05-31 |
| Last Update Date | 2024-05-31 |