# DEPARTMENT OF HEALTH & HOSPITALS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Shreveport Behavioral Health Clinic - Child & Adolescent
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871725192
- **Authorized official:** MS. ALLIE D. ALLEN (DIR. OF OPERATIONS)
- **Authorized official phone:** (318) 676-5160

## Contact information

- **Practice address:** 2924 KNIGHT ST, BUILDING III, 2ND FLOOR, SUITE 350, SHREVEPORT, LA 71105-2415
- **Practice address phone:** (318) 862-3053
- **Practice address fax:** (318) 862-3057
- **Mailing address:** 2924 KNIGHT ST, BUILDING III, 2ND FLOOR, SUITE 350, SHREVEPORT, LA 71105-2415
- **Mailing address phone:** (318) 862-3053
- **Mailing address fax:** (318) 862-3080

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | 105 | LA | Yes |

## Other

- **Enumeration date:** 08/20/2009
- **Last updated:** 07/31/2013