NPI 1023075017

Department of Health & Hospital

Organisation Substance Use Disorder Rehabilitation Clinic/Center Shreveport, LA

Practice location

Address: 1310 North Hearne Avenue, Shreveport, LA 71107
Phone: (318) 632-2040
Fax: (318) 632-2073
Mailing address: P.O. Box 7904, Shreveport, LA 71107

Authorised official

Name: Allie D. Allen
Title: Administrative Program Manager
Phone: (318) 676-5111

Registered specialties

Substance Use Disorder Rehabilitation Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QR0405X Licence 115 (LA)

Other Clinic/Center providers in Louisiana →

Registry record

NPI: 1023075017
Entity type: Organization
NPI issued: 26 Apr 2006
Record last updated: 23 Feb 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.