NPI | 1013144732 |
---|---|
Entity Type | Organization |
Authorized Contact | MARY JANE BELFIE Counselor 318-443-9246 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA 1415) |
Enumeration Date | 2009-06-20 |
Last Update Date | 2009-06-20 |