| NPI | 1932754363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMONE ELLOIE SHELTON Owner 225-252-3655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-08-02 |
| Last Update Date | 2019-08-02 |