| NPI | 1144407677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEATRICE M PARKER Owner 225-767-3099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: LA pca 14074) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2008-01-28 |