| NPI | 1457753709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA JOHNSON CEO 318-357-2055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2014-09-18 |