| Divine Behavioral Health, Llc | |
|
8870 Youree Dr Ste 105 Shreveport LA 71115-2512 | |
| (318) 347-4994 | |
| Not Available |
| Full Name | Divine Behavioral Health, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 8870 Youree Dr Ste 105, Shreveport, Louisiana |
| Authorized Official Name and Position | Veronica Douglas (OWNER/CEO) |
| Authorized Official Contact | 3183474994 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Behavioral Health, Llc 2803 Jonathan Ln Shreveport LA 71108-5531 Ph: (318) 347-4994 | Divine Behavioral Health, Llc 8870 Youree Dr Ste 105 Shreveport LA 71115-2512 Ph: (318) 347-4994 |
| NPI Number | 1801409313 |
|---|---|
| Provider Enumeration Date | 08/25/2020 |
| Last Update Date | 08/25/2020 |
| Certification Date | 08/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801409313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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