| NPI | 1821683608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAZVITA MAZIVEYI Owner 504-434-8476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| 305R00000X Preferred Provider Organization | |
| 305S00000X Point of Service | |
| 293D00000X Physiological Laboratory | |
| 302F00000X Exclusive Provider Organization | |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2022-07-12 |