| NPI | 1790151231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VONZOLLA MONIQUE ELLIOTT Owner 504-289-1067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801092790) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: MI 6801092790) |
| 305R00000X Preferred Provider Organization (Licence: MI 6801092790) | |
| 305S00000X Point of Service (Licence: MI 6801092790) | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2018-11-30 |