| NPI | 1992093132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA J LIVELY CFO 225-343-9505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QS1000X Clinic/Center Student Health |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2013-02-27 |