NPI | 1447443379 |
---|---|
Entity Type | Organization |
Authorized Contact | CHANCI S SHAW Executive Director 337-236-5575 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: LA 1522608) |
Enumeration Date | 2007-08-23 |
Last Update Date | 2007-08-23 |