| NPI | 1326013145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES VANDERHOEVEN Administrator 318-561-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: LA 016138) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2020-08-22 |