Organization
SUCCESS ADULT DAY HEALTH CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARDOSHA PEEK (CEO)
(318) 655-7375
Entity
Organization
Contact information
Practice address
211 N THOMAS DR, SHREVEPORT, LA 71107-6519
(318) 655-7375
Mailing address
211 N THOMAS DR, SHREVEPORT, LA 71107-6519
(318) 751-7173
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
01/03/2019
Last updated
06/26/2024
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