| Road To Change | |
|
2620 Centenary Blvd Ste 204 Shreveport LA 71104-3350 | |
| (318) 470-7730 | |
| Not Available |
| Full Name | Road To Change |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2620 Centenary Blvd Ste 204, Shreveport, Louisiana |
| Authorized Official Name and Position | Dana L Converse (OWNER) |
| Authorized Official Contact | 3184707730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Road To Change 9019 Toplecot Dr Shreveport LA 71129-5137 Ph: (318) 470-7730 | Road To Change 2620 Centenary Blvd Ste 204 Shreveport LA 71104-3350 Ph: (318) 470-7730 |
| NPI Number | 1518434182 |
|---|---|
| Provider Enumeration Date | 10/31/2018 |
| Last Update Date | 10/31/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518434182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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