| NPI | 1548486988 | 
|---|---|
| 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 |