| Easter Seals Louisiana Inc. | |
|
725 Jordan Street Shreveport LA 71101 | |
| (318) 221-1993 | |
| (318) 221-1995 |
| Full Name | Easter Seals Louisiana Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 725 Jordan Street, Shreveport, Louisiana |
| Authorized Official Name and Position | Tracy Garner (PRESIDENT/CEO) |
| Authorized Official Contact | 5045237325 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Easter Seals Louisiana Inc. 1010 Common Street Suite 2440 New Orleans LA 70112-2449 Ph: (504) 423-7325 | Easter Seals Louisiana Inc. 725 Jordan Street Shreveport LA 71101 Ph: (318) 221-1993 |
| NPI Number | 1538544390 |
|---|---|
| Provider Enumeration Date | 07/22/2015 |
| Last Update Date | 07/22/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538544390 | NPI | - | NPPES |
| MIS#600754983 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Louisiana) | Primary |
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