NPI | 1306455456 |
---|---|
Doing Business As | CASSE - SHREVEPORT PEDIATRICS |
Entity Type | Organization |
Authorized Contact | MARY M CHUMLEY CEO 318-688-3350 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2020-07-24 |
Last Update Date | 2020-07-24 |