| NPI | 1033390786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEATRICE M PARKER Owner 225-767-3099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: LA pca 14074) |
| Enumeration Date | 2007-11-23 |
| Last Update Date | 2008-04-08 |