| NPI | 1740977792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANGELA KACHAN FRANCIS-JOHNSON Owner 318-518-4466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2023-04-20 |
| Last Update Date | 2023-04-21 |