| NPI | 1578129391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES E MIZELL Owner 985-516-5604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253J00000X Foster Care Agency |
| Additional Taxonomies | 251S00000X |
| 253Z00000X In Home Supportive Care | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2019-05-16 |