| NPI | 1922512326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY SCOTT CEO 504-814-8001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2021-01-25 |