| NPI | 1821470188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONY CONERLY JACKSON Social Worker 225-284-6249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: LA 9158) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2015-06-23 |