| NPI | 1326387705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRELL L KINGHAM CFO 337-462-7409 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2020-11-25 |