| NPI | 1639503683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TODD CRAIGHEAD Owner/Manager 318-202-5949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Additional Taxonomies | 261QM3000X Clinic/Center, Medically Fragile Infants and Children Day Care |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2025-08-06 |