NPI | 1437394905 |
---|---|
Entity Type | Organization |
Authorized Contact | LASHUNTA SHARLAN PRINGLE Program Director 318-255-1090 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA 15139) |
Enumeration Date | 2008-12-11 |
Last Update Date | 2008-12-11 |