| NPI | 1669130621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ALLEN GREEN Owner 337-247-7282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-12-07 |
| Last Update Date | 2023-01-05 |