Organization
NORTHWEST LOUSIANA HUMAN SERVICES DISTRICT
Active
Other names
SHREVEPORT BEHAVIORAL HEALTH CLINIC, Shreveport Behavioral Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROSA BATES (ADMINISTRATIVE PROGRAM SPECIALIST A)
(318) 676-5643
Entity
Organization
Contact information
Practice address
1310 N. HEARNE AVE, SHREVEPORT, LA 71107-6516
(318) 676-5111
(318) 676-5021
Mailing address
1310 N HEARNE AVE, SHREVEPORT, LA 71107-6516
(318) 676-5643
(318) 676-5021
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
2203782546
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710083
—
LA
01
—
2203782546
BEHAVIORAL HEALTH SERVICE PROVIDER
LA
Enumeration date
08/15/2013
Last updated
11/17/2025
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