NPI | 1275987307 |
---|---|
Entity Type | Organization |
Authorized Contact | REVIA JACKOSN Administrator 504-208-9636 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X (Licence: LA 1548408958) |
Additional Taxonomies | 251S00000X (Licence: LA 1364878) |
Enumeration Date | 2016-04-14 |
Last Update Date | 2016-04-14 |