| Street Outreach Solutions,llc | |
|
2715 Mackey Pl Ste 119 Shreveport LA 71118-2527 | |
| (318) 393-5407 | |
| Not Available |
| Full Name | Street Outreach Solutions,llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2715 Mackey Pl Ste 119, Shreveport, Louisiana |
| Authorized Official Name and Position | Mar'dosha Peek (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3187717707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Street Outreach Solutions,llc 2715 Mackey Pl Ste 119 Shreveport LA 71118-2527 Ph: (318) 771-7707 | Street Outreach Solutions,llc 2715 Mackey Pl Ste 119 Shreveport LA 71118-2527 Ph: (318) 393-5407 |
| NPI Number | 1669918199 |
|---|---|
| Provider Enumeration Date | 01/08/2017 |
| Last Update Date | 06/23/2023 |
| Certification Date | 06/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669918199 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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