| NPI | 1962968511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT CRAWFORD BREEDLOVE CEO 225-802-1717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2019-02-19 |