| NPI | 1376630632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE C WHITE CEO 318-425-2252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2022-07-21 |