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Organization

ROAD TO CHANGE RESIDENTIAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANA LYNNETTE CONVERSE (OWNER)
(225) 439-1153
Entity
Organization

Contact information

Practice address
9019 TOPLECOT DR, SHREVEPORT, LA 71129-5137
(225) 439-1153
Mailing address
9019 TOPLECOT DR, SHREVEPORT, LA 71129-5137

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary

Other

Enumeration date
04/28/2026
Last updated
04/28/2026
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