Organization
INTENSIVE SPECIALTY HOSPITAL, LLC
Active
Other names
North Louisiana Whole Health Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHAIM ROTTENBERG (ASSET MANAGER)
(347) 522-5970
Entity
Organization
Contact information
Practice address
1513 LINE AVENUE, SHREVEPORT, LA 71101-4621
(318) 425-4096
(318) 424-2627
Mailing address
1513 LINE AVENUE, SUITE 115, SHREVEPORT, LA 71101-4621
(318) 425-4096
(318) 424-2627
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
04/05/2021
Last updated
06/03/2021
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