| NPI | 1720760465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISA DURAND Owner 985-956-2979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-08-02 |
| Last Update Date | 2023-08-02 |