| NPI | 1609237569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHA D HOLMES Owner 337-349-5431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 3621) |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2016-03-18 |