NPI | 1821389529 |
---|---|
Entity Type | Organization |
Authorized Contact | GLENDA WASHINGTON Executive Director 318-793-8453 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: LA ADC10580) |
Enumeration Date | 2011-04-28 |
Last Update Date | 2011-05-25 |