| NPI | 1043663040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA JACKSON Chief Executive Officer 504-662-3572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA 104100000x) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |