| NPI | 1700305679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN COVINGTON GUILBAULT Owner/ Admin Director 225-636-2910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: LA 304510) |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2022-07-21 |