| NPI | 1356718662 |
|---|---|
| Doing Business As | IBERVILLE CHARTER ACADEMY SATELLITE CLINIC |
| Entity Type | Organization |
| Authorized Contact | MARILYN B ANTWINE COO 225-642-9676 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-08-24 |