Organization
DEVELOPMENTAL RESOURCE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP CORY PRYOR (VICE PRESIDENT)
(318) 347-9978
Entity
Organization
Contact information
Practice address
1120 CRESWELL AVE, SHREVEPORT, LA 71101-3961
(318) 208-4600
(318) 603-3128
Mailing address
1120 CRESWELL AVE, SHREVEPORT, LA 71101-3961
(318) 208-4600
(318) 603-3128
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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