| NPI | 1376697664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY MIZE Administrator 337-825-6181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: LA 881) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2009-02-02 |