| NPI | 1952785040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANO THORNTON CEO 318-648-0375 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2019-06-26 |