Healthcare Provider Details

I. General information

NPI: 1811276249
Provider Name (Legal Business Name): DOBI HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2011
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6009 FINANCIAL PLZ STE 105
SHREVEPORT LA
71129
US

IV. Provider business mailing address

6009 FINANCIAL PLZ STE 105
SHREVEPORT LA
71129-2615
US

V. Phone/Fax

Practice location:
  • Phone: 318-670-8858
  • Fax: 318-670-8947
Mailing address:
  • Phone: 318-670-8858
  • Fax: 318-670-8947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: KENE NWEKE
Title or Position: HR DIRECTOR
Credential:
Phone: 318-670-8858