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Organization
RENEW THERAPEUTIC SERVICES, LLC
Active
Organization
RENEW THERAPEUTIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIERRA HEARD LCSW (OWNER)
(318) 820-6476
Entity
Organization
Contact information
Practice address
2924 KNIGHT ST STE 424, SHREVEPORT, LA 71105-2413
(318) 820-6476
Mailing address
2924 KNIGHT ST STE 424, SHREVEPORT, LA 71105-2413
(318) 820-6476
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
05/08/2019
Last updated
05/08/2019
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