| NPI | 1962134767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL SMITH-PROVOST Director 337-332-4222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251J00000X Nursing Care | |
| 251S00000X | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2023-04-02 |