| 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 |