| NPI | 1922599380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ADAMS COO 318-648-0375 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| 1041C0700X Social Worker Clinical | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2019-06-26 |