Organization
RED RIVER BEHAVIORAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN KOTTENBROOK (DIRECTOR/ ADMINISTRATOR)
(318) 549-2033
Entity
Organization
Contact information
Practice address
2800 MELROSE AVE, BOSSIER CITY, LA 71111
(318) 549-2033
(318) 549-3745
Mailing address
2800 MELROSE AVE, BOSSIER CITY, LA 71111-5870
(318) 549-2033
(318) 549-3745
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
572
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1709565
—
LA
Enumeration date
06/16/2006
Last updated
03/17/2020
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