| NPI | 1699024448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN EBANKS Owner 504-256-3478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA applied for) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2023-06-23 |