| NPI | 1457701575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYELLE OATIS-GASKEW Lead Credentialing Specialist 504-482-4080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2023-12-18 |