| NPI | 1902316763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY MISTRIC CEO 337-237-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 104100000X Social Worker | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 163WM0705X Registered Nurse, Medical-Surgical | |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2025-11-06 |