Organization
CW OUTREACH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMRI DOUGLAS (EXECUTIVE DIRECTOR)
(318) 523-4103
Entity
Organization
Contact information
Practice address
4229 US-79, HOMER, LA 71040
(318) 523-4103
Mailing address
PO BOX 622, HOMER, LA 71040-0622
(318) 523-4103
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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