| NPI | 1689020489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY O'NEAL SHOWERS Mbr 985-520-5697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2023-09-21 |