Organization
SUPPORTIVE INTEGRATED SERVICES INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY WRIGHT (DIRECTOR)
(318) 675-0406
Entity
Organization
Contact information
Practice address
842 MARGARET PL, SHREVEPORT, LA 71101-4521
(318) 675-0406
(318) 675-0408
Mailing address
842 MARGARET PL, SHREVEPORT, LA 71101-4521
(318) 675-0406
(318) 675-0408
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/02/2011
Last updated
05/02/2011
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