Holy Angels Residential Facility | |
10450 Ellerbe Rd Shreveport LA 71106-7730 | |
(318) 423-6685 | |
Not Available |
Full Name | Holy Angels Residential Facility |
---|---|
Speciality | Community/behavioral Health |
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 Residential Facility 10450 Ellerbe Rd Shreveport LA 71106-7730 Ph: (318) 423-6685 | Holy Angels Residential Facility 10450 Ellerbe Rd Shreveport LA 71106-7730 Ph: (318) 423-6685 |
NPI Number | 1679211718 |
---|---|
Provider Enumeration Date | 05/26/2022 |
Last Update Date | 05/26/2022 |
Certification Date | 05/26/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679211718 | NPI | - | NPPES |
1639345853 | Medicaid | LA | |
1861747636 | Medicaid | LA | |
1073732749 | Medicaid | LA | |
1619196383 | Medicaid | LA | |
1346469012 | Medicaid | LA | |
1497173090 | Medicaid | LA | |
1578014387 | Medicaid | LA | |
1437378106 | Medicaid | LA | |
1528287299 | Medicaid | LA | |
1982823654 | Medicaid | LA | |
1992924658 | Medicaid | LA | |
1225256035 | Medicaid | LA | |
1184843849 | Medicaid | LA | |
1770750747 | Medicaid | LA | |
1164641833 | Medicaid | LA | |
1316165418 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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