| NPI | 1659720506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERNEY THOMAS CEO 337-363-4521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA HC0006113) |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2016-06-10 |