| Community Enrichment Programs Llc | |
|
842 Margaret Pl Shreveport LA 71101-4521 | |
| (318) 675-0406 | |
| (318) 675-0408 |
| Full Name | Community Enrichment Programs Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 842 Margaret Pl, Shreveport, Louisiana |
| Authorized Official Name and Position | Tammy Michelle Plater (PRESIDENT ADMINISTRATOR) |
| Authorized Official Contact | 3186750406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Enrichment Programs Llc 2015 Fairfield Ave Ste 1a Shreveport LA 71104-2066 Ph: (318) 675-0406 | Community Enrichment Programs Llc 842 Margaret Pl Shreveport LA 71101-4521 Ph: (318) 675-0406 |
| NPI Number | 1568534857 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 12/14/2022 |
| Certification Date | 12/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568534857 | NPI | - | NPPES |
| 1103926 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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