Organization
DISCRETE ENTERPRISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA MARIE ALLEN BOARD CERTIFIED COUN (CEO)
(318) 617-5100
Entity
Organization
Contact information
Practice address
5100 PINE HILL RD, SHREVEPORT, LA 71107
(318) 617-5100
Mailing address
5100 PINE HILL RD, SHREVEPORT, LA 71107-2604
(318) 617-5100
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
10010142961
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10010142961
COUNSELING
—
Enumeration date
07/02/2018
Last updated
07/02/2018
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