| NPI | 1548384910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY J ORTEGO Administrator 318-640-4340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: LA CM2052) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2016-03-15 |