NPI | 1588656581 |
---|---|
Entity Type | Organization |
Authorized Contact | EARL J WILDE Chairman Of The Board 225-810-4040 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2005-08-17 |
Last Update Date | 2009-11-05 |