| Shreveport Behavioral Health Clinic | |
|
1310 North Hearne Ave. Shreveport LA 71107 | |
| (318) 676-5111 | |
| (318) 676-5021 |
| Full Name | Shreveport Behavioral Health Clinic |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1310 North Hearne Ave., Shreveport, Louisiana |
| Authorized Official Name and Position | Allie D. Allen (DIR. OF OPERATIONS) |
| Authorized Official Contact | 3186765160 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shreveport Behavioral Health Clinic Po Box 7904 Shreveport LA 71137-7904 Ph: (318) 676-5111 | Shreveport Behavioral Health Clinic 1310 North Hearne Ave. Shreveport LA 71107 Ph: (318) 676-5111 |
| NPI Number | 1215083332 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 07/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215083332 | NPI | - | NPPES |
| 1710083 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 105 (Louisiana) | Primary |
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