NPI | 1215191481 |
---|---|
Entity Type | Organization |
Authorized Contact | GLENDA SCOTT WASHINGTON Director 318-793-8453 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: LA 10531) |
Enumeration Date | 2008-07-16 |
Last Update Date | 2008-07-16 |