| NPI | 1992187322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEMMALYN PRYOR Seaside Hc Billing Supervisor 337-234-8280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X (Licence: LA SA0010541) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2023-07-07 |