NPI | 1649644675 |
---|---|
Entity Type | Organization |
Authorized Contact | SARAH CARROLL HAMAUEI Owner/Physician 318-218-1299 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: LA 201778) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: LA 201778) |
Enumeration Date | 2015-11-13 |
Last Update Date | 2017-02-28 |