| NPI | 1598289399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY PHELPS Owner 504-301-0811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2023-06-22 |