Organization
NEW AWAKENINGS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANSHUMAN JYOTI M.D. (OWNER)
(818) 438-9091
Entity
Organization
Contact information
Practice address
4440 VIKING DR, SUITE 300-400, BOSSIER CITY, LA 71111-7511
(318) 584-7137
(318) 584-7140
Mailing address
4440 VIKING DR, SUITE 300-400, BOSSIER CITY, LA 71111-7511
(318) 584-7137
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD204139
LA
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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