| NPI | 1447324132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAZEL BRAUEN Business Manager 985-871-1721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0800X (Licence: LA 88) |
| Additional Taxonomies | 261QE0800X (Licence: LA 120) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2023-05-15 |