NPI | 1417113267 |
---|---|
Entity Type | Organization |
Authorized Contact | REBECCA V SNEED-MATTHEWS Chief Administrator 318-213-2273 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: LA 20081) |
Enumeration Date | 2008-07-31 |
Last Update Date | 2008-07-31 |