# BROWN SUGAR HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013732940
- **Authorized official:** DR. DERRICK WAYNE SMITH MD (CEO)
- **Authorized official phone:** (818) 515-7991

## Contact information

- **Practice address:** 507 BROMPTON LN, BOSSIER CITY, LA 71111-8208
- **Practice address phone:** (818) 515-7991
- **Mailing address:** 507 BROMPTON LN, BOSSIER CITY, LA 71111-8208
- **Mailing address phone:** (818) 515-7991

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/15/2024
- **Last updated:** 06/06/2026