| NPI | 1710471263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWANNA GUILLORY Owner 337-384-9219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: LA AP07537) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2021-02-16 |