NPI | 1972125813 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID ADAMS COO 318-648-0375 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Enumeration Date | 2020-05-14 |
Last Update Date | 2020-05-14 |