NPI | 1134464464 |
---|---|
Entity Type | Organization |
Authorized Contact | LASHONDA GIPSON Clinical Director 504-460-4193 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: LA 3937) |
Enumeration Date | 2012-11-27 |
Last Update Date | 2012-11-27 |