| NPI | 1568731602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODERICK CAMPBELL CEO 337-365-4945 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2024-01-31 |