| NPI | 1487804779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD DE LA HOUSSAYE Program Sponsor 337-332-4878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: LA 244) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2008-09-24 |