| NPI | 1255911970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE CHAUVIN DANIELSON Administrator 985-200-1213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2021-04-08 |