| NPI | 1104057694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KANDI G. MOORE CEO 318-632-6083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: LA 626) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2011-05-06 |