| NPI | 1104249473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE WHITE CEO 318-227-3350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2014-01-22 |