Organization
WK BEHAVORIAL HEALTH MED CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-4232
Entity
Organization
Contact information
Practice address
2300 HOSPITAL DR, SUITE 340, BOSSIER CITY, LA 71111-2394
(318) 212-7461
(318) 212-7465
Mailing address
1202 LOUISIANA AVE, SHREVEPORT, LA 71101-3910
(318) 212-8946
(318) 212-4153
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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