Organization
HEROES FIRST MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESSE L FALLIS SR. LPC (LICENSED PROFESSIONAL COUNSELOR)
(318) 218-2360
Entity
Organization
Contact information
Practice address
5657 N LAKESHORE DR, SHREVEPORT, LA 71107-9382
(318) 218-2360
(318) 668-7811
Mailing address
5657 N LAKESHORE DR, SHREVEPORT, LA 71107-9382
(318) 218-2360
(318) 668-7811
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538615067
JESSE FALLIS
LA
Enumeration date
03/25/2024
Last updated
03/25/2024
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