| NPI | 1649417346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMSON PRESAD COO 225-214-1617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA NEW ENTITY) |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2015-11-20 |