Organization · Type 2 NPI
Department of Health & Hospital
Substance Use Disorder Rehabilitation Clinic/Center · Shreveport, LA
NPI number
1023075017
Active
Practice location
1310 North Hearne Avenue
Shreveport, LA 71107
Fax (318) 632-2073
Mailing address
P.o. Box 7904
Shreveport, LA 71107
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center Primary | 261QR0405X | 115 (LA) |
Substance Use Disorder Rehabilitation Clinic/Center: Definition to come...
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About NPI 1023075017
Department of Health & Hospital's National Provider Identifier is 1023075017, issued on Apr 26, 2006. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in Shreveport, LA. The record was last updated on Feb 23, 2012.