| NPI | 1790156263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD CHARLES LEWIS Owner 504-915-1467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 4462) |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2015-10-09 |