| NPI | 1063782811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY M MORRIS Administrator 318-728-8833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: LA 157) |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2012-01-11 |