| Blue Shepherd Behavioral Supports, Llc | |
|
14036 Riverlake Dr Covington LA 70435-5513 | |
| (404) 543-4897 | |
| Not Available |
| Full Name | Blue Shepherd Behavioral Supports, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 14036 Riverlake Dr, Covington, Louisiana |
| Authorized Official Name and Position | Michael Schafer (DIRECTOR) |
| Authorized Official Contact | 4045434897 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Shepherd Behavioral Supports, Llc 14036 Riverlake Dr Covington LA 70435-5513 Ph: (404) 543-4897 | Blue Shepherd Behavioral Supports, Llc 14036 Riverlake Dr Covington LA 70435-5513 Ph: (404) 543-4897 |
| NPI Number | 1891466603 |
|---|---|
| Provider Enumeration Date | 09/22/2021 |
| Last Update Date | 09/22/2021 |
| Certification Date | 09/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891466603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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