| NPI | 1114740438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH SPIKES Admin 318-556-8454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-11-05 |
| Last Update Date | 2024-11-05 |