# RESIDUAL CARE LLC

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

## Provider details

- **NPI number:** 1710685128
- **Authorized official:** VERONICA BLAZE (OWNER)
- **Authorized official phone:** (318) 459-7702

## Contact information

- **Practice address:** 8575 FERN AVE STE 108, SHREVEPORT, LA 71105-5677
- **Practice address phone:** (318) 459-7702
- **Mailing address:** 679 KINGS TOWNE PL, SHREVEPORT, LA 71108-6034
- **Mailing address phone:** (318) 399-2274

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 02/16/2023
- **Last updated:** 04/04/2024