| NPI | 1962749275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEARL RICHARD NELSON Owner 337-429-5129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2023-06-29 |