Organization
SHREVEPORT BEHAVIORAL HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY GOAD LCSW (REGIONAL ADMINISTRATOR)
(318) 676-5111
Entity
Organization
Contact information
Practice address
1310 N HEARNE AVE, SHREVEPORT, LA 71107-6516
(318) 676-5111
Mailing address
1310 N HEARNE AVE, SHREVEPORT, LA 71107-6516
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
LA
Other
Enumeration date
05/30/2013
Last updated
05/30/2013
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