| NPI | 1982323465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL PROVOST Administratiion 337-347-4718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-08-26 |
| Last Update Date | 2022-08-26 |