Organization
CHANGING BEHAVIOR SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA MICHELLE PHILLIPS MBA (OWNER)
(318) 617-5869
Entity
Organization
Contact information
Practice address
1434 HAWN AVE, STE. 12, SHREVEPORT, LA 71107-6508
(318) 675-0224
(318) 675-0226
Mailing address
PO BOX 7875, SHREVEPORT, LA 71137-7875
(318) 675-0224
(318) 675-0226
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
10111532#MVA42
LA
251S00000X
Community/Behavioral Health Agency
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Other
Enumeration date
02/15/2011
Last updated
06/02/2022
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