| NPI | 1942508510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIBBERLY G RICHARD Owner / Administrator 337-942-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-03-07 |
| Last Update Date | 2011-03-07 |