| NPI | 1356123350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN GAST Cred Manager 985-635-6943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2025-03-14 |