| NPI | 1962134767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE D JONES Director 337-296-0467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2025-09-18 |