| NPI | 1740539410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARISSA TAYLOR Owner 985-778-9141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: LA ap03867) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2012-09-10 |