| NPI | 1962870584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT MATHERNE Administrator/Clinical Director 985-223-4009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 431) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2015-09-14 |