| NPI | 1629460456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN JOSEPH KNIGHTSHEAD Owner 225-937-3189 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2015-03-03 |