| NPI | 1831916451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRA STEWART Manager 318-773-8241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 363L00000X Nurse Practitioner | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363LS0200X Nurse Practitioner, School | |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2024-09-24 |