| NPI | 1356415996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES P NEELEY Regional Director Of Operations 985-774-9609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-08-22 |