| NPI | 1700531993 |
|---|---|
| Doing Business As | MAISON DE LAFAYETTE |
| Entity Type | Organization |
| Authorized Contact | CHARLES MOODY Authorized Agent 225-939-6766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2022-02-16 |
| Last Update Date | 2022-02-18 |