| NPI | 1689055683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS N TRAHAN Medical Director 225-658-4110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: LA MD.018535) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-06-15 |