| NPI | 1255156113 |
|---|---|
| Former Legal Business Name | LAKE CRESCENT HEALTH CONSULTING, LLC |
| Entity Type | Organization |
| Authorized Contact | LAKEISHA MACK LONG Owner 225-831-6111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-11-18 |
| Last Update Date | 2025-12-03 |