Source Of Solutions Counseling Service, Llc | |
2285 Benton Rd Ste D103 Bossier City LA 71111-3465 | |
(318) 584-7197 | |
(318) 584-7080 |
Full Name | Source Of Solutions Counseling Service, Llc |
---|---|
Speciality | Clinic/Center |
Location | 2285 Benton Rd Ste D103, Bossier City, Louisiana |
Authorized Official Name and Position | Roslyn Stumon (OWNER/ADMINISTRATOR) |
Authorized Official Contact | 3185847197 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Source Of Solutions Counseling Service, Llc 2285 Benton Rd Ste D103 Bossier City LA 71111-3465 Ph: (318) 584-7197 | Source Of Solutions Counseling Service, Llc 2285 Benton Rd Ste D103 Bossier City LA 71111-3465 Ph: (318) 584-7197 |
NPI Number | 1013363654 |
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Provider Enumeration Date | 05/12/2016 |
Last Update Date | 06/13/2023 |
Certification Date | 06/13/2023 |
Medicare PECOS PAC ID | 2860756244 |
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Medicare Enrollment ID | O20180511000292 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013363654 | NPI | - | NPPES |
Provider Name | Gregory J. Brown |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1821058181 PECOS PAC ID: 9234375221 Enrollment ID: I20130417000579 |
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