NPI | 1821566886 |
---|---|
Entity Type | Organization |
Authorized Contact | CASSIE M BROUSSARD Owner/Np 337-322-2347 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Enumeration Date | 2018-11-07 |
Last Update Date | 2022-06-01 |