| NPI | 1821248279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUEBEN S BIENVENU Program Sponsor 337-298-1257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: MS MS-10003-M) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2021-06-17 |