| NPI | 1124427547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCARLETT CAIN LANDRY Owner 337-380-5849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: LA 3063) |
| Additional Taxonomies | 251S00000X (Licence: LA MFT 980) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |