| NPI | 1407253883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIS WALKER Program Director 985-224-2199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2019-11-11 |