Organization
EXCEPTIONAL WELLNESS OF LOUISIANA INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATONIA KENT (ADMINISTRATOR)
(318) 383-1607
Entity
Organization
Contact information
Practice address
331 MILAM ST, SHREVEPORT, LA 71101-5353
(318) 383-1607
Mailing address
2440 TEXAS PKWY STE 335, MISSOURI CITY, TX 77489-4098
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
06/10/2020
Last updated
08/06/2020
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