| NPI | 1952858953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAKERA L MCKENZIE Executive Director 337-508-9023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 252Y00000X Early Intervention Provider Agency | |
| 305S00000X Point of Service | |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2016-09-07 |