| NPI | 1437298304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE J LEBOEUF Executive Director 337-363-5161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA pca 3677) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2007-08-15 |