| NPI | 1497989446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAREKIA SHATEAU BROWN Owner/ Operator 985-709-4045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2009-05-05 |