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Organization

BE YOU OUTREACH CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KATHY W SCOTT (CEO)
(318) 626-5626
Entity
Organization

Contact information

Practice address
7505 PINES RD, SUITE 1295, SHREVEPORT, LA 71129-3935
(318) 626-5626
(318) 626-5726
Mailing address
7505 PINES ROAD, SUITE 1295, SHREVEPORT, LA 71129
(318) 626-5626
(318) 626-5726

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
251S00000X
LA
05
251T00000X
LA
05
261QM0801X
LA
Enumeration date
03/23/2017
Last updated
03/23/2017
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