| NPI | 1578182838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHAEL SHANNEL COSTLY CEO 225-788-7048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251B00000X Case Management | |
| 251E00000X Home Health | |
| 251S00000X | |
| 253Z00000X In Home Supportive Care | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2020-04-15 |