NPI | 1871766485 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBINETT WEBB Executive Director 318-681-9988 |
Organization Subpart ? | No |
Primary Taxonomy | 251T00000X PACE Provider Organization (Licence: LA 9632) |
Enumeration Date | 2008-04-04 |
Last Update Date | 2017-12-19 |