| NPI | 1538385505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET ROBINSON Director Of Administrative Services 318-247-4213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA 6736) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-08-22 |