| Holy Angels Autism Center | |
|
10450 Ellerbe Rd Shreveport LA 71106-7712 | |
| (318) 797-8500 | |
| (318) 797-0801 |
| Full Name | Holy Angels Autism Center |
|---|---|
| Speciality | Behavior Analyst |
| Location | 10450 Ellerbe Rd, Shreveport, Louisiana |
| Authorized Official Name and Position | Christina Landry Horne (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 3187978500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Holy Angels Autism Center 10450 Ellerbe Rd Shreveport LA 71106-7712 Ph: (318) 797-8500 | Holy Angels Autism Center 10450 Ellerbe Rd Shreveport LA 71106-7712 Ph: (318) 797-8500 |
| NPI Number | 1578014387 |
|---|---|
| Provider Enumeration Date | 10/17/2016 |
| Last Update Date | 05/27/2022 |
| Certification Date | 05/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578014387 | NPI | - | NPPES |
| 2431641 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
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