| NPI | 1992067540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN LOUISE WILLIAMS Owner 337-302-3023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 4611) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2012-06-11 |