Organization
CHANGING BEHAVIOR SERVICES OF MINDEN LLC
Active
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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