| NPI | 1114293610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA MARIE DUHON Managing Member/Owner 337-322-9208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA 70501-4724) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2018-06-20 |