Organization
CHANGING BEHAVIOR SERVICES OF MINDEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA MICHELLE PHILLIPS MBA (BUSINESS MANAGER)
(318) 617-5869
Entity
Organization
Contact information
Practice address
601 HOMER RD, MINDEN, LA 71055-2909
(318) 371-6707
(318) 377-8164
Mailing address
PO BOX 78776, SHREVEPORT, LA 71137-8776
(318) 371-6707
(318) 377-8164
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
10334080#B4P83
LA
Other
Enumeration date
12/27/2012
Last updated
12/02/2017
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