| Chemical Dependency Services, Llc | |
|
1545 Line Ave Ste 170 Shreveport LA 71101-4629 | |
| (318) 425-3333 | |
| (225) 208-1850 |
| Full Name | Chemical Dependency Services, Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1545 Line Ave Ste 170, Shreveport, Louisiana |
| Authorized Official Name and Position | Robert Layne Bonvillain (OWNER) |
| Authorized Official Contact | 3184253333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chemical Dependency Services, Llc 1545 Line Ave Ste 170 Shreveport LA 71101-4629 Ph: (318) 425-3333 | Chemical Dependency Services, Llc 1545 Line Ave Ste 170 Shreveport LA 71101-4629 Ph: (318) 425-3333 |
| NPI Number | 1659403921 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659403921 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 316 (Louisiana) | Primary |
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