| Northwest Cmhc, L.l.c. | |
|
2121 Fairfield Ave Suite 210/220 Shreveport LA 71104-2057 | |
| (225) 892-6119 | |
| Not Available |
| Full Name | Northwest Cmhc, L.l.c. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2121 Fairfield Ave, Shreveport, Louisiana |
| Authorized Official Name and Position | David Harris (MEMBER) |
| Authorized Official Contact | 2258926119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Cmhc, L.l.c. 1813 Rosale Dr Baton Rouge LA 70806-8566 Ph: (225) 892-6119 | Northwest Cmhc, L.l.c. 2121 Fairfield Ave Suite 210/220 Shreveport LA 71104-2057 Ph: (225) 892-6119 |
| NPI Number | 1366687527 |
|---|---|
| Provider Enumeration Date | 12/02/2008 |
| Last Update Date | 12/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366687527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | NA (* (Not Available)) | Primary |
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