| NPI | 1659160323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN PAGOADA Title Mgr 985-774-1497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2025-05-01 |
| Last Update Date | 2025-05-01 |