Organization
WILLIS KNIGHTON MEDICAL CENTER, INC.
Active
Other names
Willis Knighton Behavioral Medicine Unit
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JANE WARD (CFO)
(318) 212-4384
Entity
Organization
Contact information
Practice address
1111 LINE AVENUE, SHREVEPORT, LA 71101
(318) 212-5000
(318) 212-4192
Mailing address
PO BOX 32600, SHREVEPORT, LA 71130-2600
(318) 212-5000
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
232A
LA
Other
Enumeration date
01/18/2007
Last updated
02/17/2017
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