| NPI | 1316478076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIONNE SMITH-CROSBY Program Director 225-246-2162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-03-24 |