| NPI | 1720519903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDUARDO HERNANDEZ Chief Executive Officer 985-646-1580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2017-03-21 |