Organization
CBS ACT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA MICHELLE PHILLIPS MBA (BUSINESS MANAGER)
(318) 617-5869
Entity
Organization
Contact information
Practice address
151 FREESTATE BLVD, SHREVEPORT, LA 71107-6535
(318) 226-5990
(318) 226-5994
Mailing address
PO BOX 7875, SHREVEPORT, LA 71137-7875
(318) 617-5869
(318) 226-5994
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
10334076#LUL73
LA
251B00000X
Case Management Agency
10334076#LUL73
LA
251S00000X
Community/Behavioral Health Agency
Primary
10334076#LUL73
LA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
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Other
Enumeration date
12/27/2012
Last updated
06/28/2023
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