| Johnson Behavioral Health Group | |
|
4830 Line Ave Ste 302 Shreveport LA 71106-1530 | |
| (318) 379-4488 | |
| Not Available |
| Full Name | Johnson Behavioral Health Group |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4830 Line Ave Ste 302, Shreveport, Louisiana |
| Authorized Official Name and Position | Abigail Johnson (CEO) |
| Authorized Official Contact | 3183794488 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Johnson Behavioral Health Group 4830 Line Ave Ste 302 Shreveport LA 71106-1530 Ph: (318) 379-4488 | Johnson Behavioral Health Group 4830 Line Ave Ste 302 Shreveport LA 71106-1530 Ph: (318) 379-4488 |
| NPI Number | 1063019156 |
|---|---|
| Provider Enumeration Date | 10/02/2020 |
| Last Update Date | 10/02/2020 |
| Certification Date | 09/26/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063019156 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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