| NPI | 1619793445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON LAVAR TRIGGS Administrator 225-810-0261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2024-11-26 |
| Last Update Date | 2025-01-02 |