Organization
FRESH START FAMILY SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA M GILES (CEO)
(318) 422-3547
Entity
Organization
Contact information
Practice address
405 HEARNE AVE, SHREVEPORT, LA 71103-2021
(318) 422-3547
Mailing address
405 HEARNE AVE, SHREVEPORT, LA 71103-2021
(318) 422-3547
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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