| NPI | 1780199265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA MARIE BENANDI Billing Specicalist 504-704-5949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: LA Lalcs31529) |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2018-03-17 |