| NPI | 1164451464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRICIA L LACAVICH President 318-407-1785 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QI0500X Clinic/Center Infusion Therapy (Licence: KS A-046-062) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2022-10-19 |