Organization
UPRISING ADDICTION CENTER, LLC
Active
Organization
UPRISING ADDICTION CENTER, LLC
Active
Other names
Uprising Addiction Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARY TALBERT (CREDENTIALING MANAGER)
(337) 794-1585
Entity
Organization
Contact information
Practice address
7020 KLUG PINES RD, SHREVEPORT, LA 71129-3300
(337) 855-9023
(337) 855-1829
Mailing address
7020 KLUG PINES RD, SHREVEPORT, LA 71129-3300
(337) 855-9023
(337) 855-1829
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
207RP1001X
Pulmonary Disease Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
09/28/2021
Last updated
05/01/2023
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