Organization
ZODIAC HOLDING GROUP
Active
Other names
INTEGRATIVE COUNSELING AND WELLNESS
Organization subpart
No
Provider details
NPI number
Authorized official
VAN BIVENS LCSW (CEO/SOLE MEMBER)
(318) 459-8927
Entity
Organization
Contact information
Practice address
3611 GREENWAY PL, SHREVEPORT, LA 71105-2011
(318) 459-8927
Mailing address
3611 GREENWAY PL, SHREVEPORT, LA 71105-2011
(318) 459-8927
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/23/2018
Last updated
01/23/2018
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