NPI | 1023162153 |
---|---|
Entity Type | Organization |
Authorized Contact | EUGENE J LEBOEUF Executive Director 337-363-5161 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA PCA 3677) |
Enumeration Date | 2007-01-23 |
Last Update Date | 2007-08-15 |