Organization
MARTIN LUTHER KING HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANET M MENTESANE (EXECUTIVE DIRECTOR)
(318) 227-2912
Entity
Organization
Contact information
Practice address
1233 SPRAGUE ST., SHREVEPORT, LA 71101
(318) 227-2912
(318) 227-8105
Mailing address
1233 SPRAGUE ST., SHREVEPORT, LA 71101
(318) 227-2912
(318) 227-8105
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
333600000X
Pharmacy
2441-CH
LA
Other
Enumeration date
04/09/2009
Last updated
04/09/2009
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