| 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 |