Organization
REHABILITATION SERVICES OF NORTHWEST LOUISIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW ST. AMANT (OWNER/OPERATOR)
(318) 675-0804
Entity
Organization
Contact information
Practice address
1301 YOUREE DR, SHREVEPORT, LA 71101-5117
(318) 675-0804
(318) 425-9030
Mailing address
1000 CHINABERRY DR STE 900, BOSSIER CITY, LA 71111-2455
(318) 746-0420
(318) 626-5429
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1151254
LA
Other
Enumeration date
11/03/2006
Last updated
06/19/2023
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