| NPI | 1033875554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVICIA BROWN STEPHENS LAKE Owner 504-814-1277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2021-11-09 |