| NPI | 1811126550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALVADORE VILLALON Clinical Director 318-335-4466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health (Licence: CA A80985) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2009-07-02 |