| NPI | 1346423100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE NICHOLE SANDERS Office Manager 225-925-5244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: LA 14061) |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2007-12-14 |