| NPI | 1609351477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE NEWMAN Billing Manager 337-582-2034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2020-03-25 |