NPI | 1770775108 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNETH AVERY VICTOR Administrator 985-651-7887 |
Organization Subpart ? | No |
Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: LA 10007) |
Additional Taxonomies | 385H00000X Respite Care (Licence: LA 9581) |
Enumeration Date | 2007-08-09 |
Last Update Date | 2007-08-09 |