Healthcare Provider Details

I. General information

NPI: 1285850206
Provider Name (Legal Business Name): METROPOLITAN CIRCLES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3510 LINWOOD AVE
SHREVEPORT LA
71103-4512
US

IV. Provider business mailing address

3510 LINWOOD AVE
SHREVEPORT LA
71103-4512
US

V. Phone/Fax

Practice location:
  • Phone: 318-636-4194
  • Fax: 318-636-4196
Mailing address:
  • Phone: 318-636-4194
  • Fax: 318-636-4196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number8360
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CARLTON SMITH
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 318-636-4194