| NPI | 1881138899 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KENDALL HERBERT BROWN Owner 225-718-0991  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 5251)  | 
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | 
| Enumeration Date | 2016-12-09 | 
| Last Update Date | 2023-07-06 |