| NPI | 1982735411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARION PEEL Chief Financial Officer 318-249-4562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA 9807) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |