Organization
D & K CARE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEROY EALY (ADMINISTRATOR)
(318) 631-0805
Entity
Organization
Contact information
Practice address
3200 HOLLYWOOD AVE, SHREVEPORT, LA 71108
(318) 631-0805
(318) 631-1192
Mailing address
4185 DEER CREEK DRIVE, SHREVEPORT, LA 71119-7513
(318) 631-5258
(318) 631-1192
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1324426
—
LA
01
—
1479969
PROVIDER NUMBER
LA
05
—
1788350
—
LA
Enumeration date
01/19/2007
Last updated
05/17/2023
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