Organization
RESIDUAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA BLAZE (OWNER)
(318) 459-7702
Entity
Organization
Contact information
Practice address
8575 FERN AVE STE 108, SHREVEPORT, LA 71105-5677
(318) 459-7702
Mailing address
679 KINGS TOWNE PL, SHREVEPORT, LA 71108-6034
(318) 399-2274
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
02/16/2023
Last updated
04/04/2024
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