| Residual Care Llc | |
|
8575 Fern Ave Ste 108 Shreveport LA 71105-5677 | |
| (318) 459-7702 | |
| Not Available |
| Full Name | Residual Care Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 8575 Fern Ave Ste 108, Shreveport, Louisiana |
| Authorized Official Name and Position | Veronica Blaze (OWNER) |
| Authorized Official Contact | 3184597702 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Residual Care Llc 679 Kings Towne Pl Shreveport LA 71108-6034 Ph: (318) 399-2274 | Residual Care Llc 8575 Fern Ave Ste 108 Shreveport LA 71105-5677 Ph: (318) 459-7702 |
| NPI Number | 1710685128 |
|---|---|
| Provider Enumeration Date | 02/16/2023 |
| Last Update Date | 04/04/2024 |
| Certification Date | 04/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710685128 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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