| NPI | 1669598322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE DEPRIEST LEVASSEUR Administrator 337-269-0136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 012306) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2012-02-15 |