Organization
INTENSIVE SPECIALTY HOSPITAL, LLC
Active
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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