| Cbs Act Center Llc | |
|
151 Freestate Blvd Shreveport LA 71107-6535 | |
| (318) 226-5990 | |
| (318) 226-5994 |
| Full Name | Cbs Act Center Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 151 Freestate Blvd, Shreveport, Louisiana |
| Authorized Official Name and Position | Pamela Michelle Phillips (BUSINESS MANAGER) |
| Authorized Official Contact | 3186175869 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cbs Act Center Llc Po Box 7875 Shreveport LA 71137-7875 Ph: (318) 617-5869 | Cbs Act Center Llc 151 Freestate Blvd Shreveport LA 71107-6535 Ph: (318) 226-5990 |
| NPI Number | 1396081097 |
|---|---|
| Provider Enumeration Date | 12/27/2012 |
| Last Update Date | 06/28/2023 |
| Certification Date | 06/28/2023 |
| Medicare PECOS PAC ID | 4082992680 |
|---|---|
| Medicare Enrollment ID | O20161102002305 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396081097 | NPI | - | NPPES |
| Provider Name | Gregory Scott Seal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811947153 PECOS PAC ID: 2668432071 Enrollment ID: I20110610000470 |
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