| NPI | 1902202278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA PAUL PATRICK Owner 225-454-3744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA Ap07070) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2024-08-06 |