| NPI | 1932930906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK DANIELS Executive Director 337-577-2112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2024-08-12 |