| NPI | 1417194325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALENCIA FULLER MAGEE Manager 225-647-0580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: LA 1756) |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2009-01-14 |