| NPI | 1831369420 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | ANTONIO BERNARD NASH Owner 318-742-0362 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251T00000X PACE Provider Organization |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2008-03-10 |