| NPI | 1639231277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA ANN WILSON Administrator 337-363-7879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: LA 11307) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |