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 |