| NPI | 1235468687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA M JACKSON CEO 225-385-4617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2009-12-14 |
| Last Update Date | 2009-12-14 |