NPI | 1437274974 |
---|---|
Entity Type | Organization |
Authorized Contact | CINDY S PARKER Regional Coordinator 318-636-0390 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: LA 11882) |
Enumeration Date | 2007-03-21 |
Last Update Date | 2020-08-22 |