| NPI | 1124558630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH WILLIAM BASHA Owner 318-623-0890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider (Licence: LA 2203783331) |
| Enumeration Date | 2017-06-16 |
| Last Update Date | 2022-07-21 |