| NPI | 1356661300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERNEY THOMAS CEO 337-363-4521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: LA 554047) |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2010-06-01 |