Organization
MIND REHABILITATION & RESOURCE CENTER
Active
Other names
Mind Rehabilitation & Resource Center
Organization subpart
No
Provider details
NPI number
Authorized official
LATOYTA DANIELLE MANDOSIA (MHS)
(318) 828-1455
Entity
Organization
Contact information
Practice address
1513 LINE AVE # 135, SHREVEPORT, LA 71101-4621
(318) 828-1455
(318) 828-1626
Mailing address
1513 LINE AVE # 135, SHREVEPORT, LA 71101-4621
(318) 828-1455
(318) 828-1626
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
LA
Other
Enumeration date
04/21/2016
Last updated
04/21/2016
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