| NPI | 1396310256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ADAMS COO 318-648-0375 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2021-05-24 |