| NPI | 1346613700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROYSHANDA CZELL SMITG Owner 504-957-3448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: AL 29098) |
| Enumeration Date | 2015-11-07 |
| Last Update Date | 2015-11-07 |