| NPI | 1942654686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUJAN JOHNSON CEO 225-448-5399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) |
| 261QS1000X Clinic/Center, Student Health | |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2020-07-21 |