NPI | 1609990886 |
---|---|
Entity Type | Organization |
Authorized Contact | ANGELA T. TONEY President 985-781-1041 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: LA 9578) |
Additional Taxonomies | 305S00000X Point of Service (Licence: LA 12549) |
Enumeration Date | 2007-03-16 |
Last Update Date | 2020-08-22 |