| NPI | 1871141986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLIE COCHRAN Owner 337-502-9533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 251B00000X Case Management | |
| 251S00000X | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2019-09-01 |
| Last Update Date | 2019-09-01 |