| NPI | 1932440500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA MARIE BENANDI Billing 504-704-5949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: LA LALCS31529) |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2018-03-02 |