| NPI | 1033552385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE SMITH Administrator/Don 318-355-3204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM3000X Clinic/Center, Medically Fragile Infants and Children Day Care |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2024-10-07 |