| NPI | 1881138899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDALL HERBERT BROWN Owner 225-718-0991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (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 |