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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