Organization
A1 NORTHWEST LA INCS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY S PARKER R.N. (REGIONAL COORDINATOR)
(318) 636-0390
Entity
Organization
Contact information
Practice address
103 W ALABAMA AVE, RUSTON, LA 71270-4403
(318) 513-9038
Mailing address
PO BOX 1345, RUSTON, LA 71273-1345
(318) 513-9038
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
11882
LA
Other
Enumeration date
08/22/2007
Last updated
08/22/2007
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