Healthcare Provider Details

I. General information

NPI: 1912186131
Provider Name (Legal Business Name): COMMUNITY HEALTHCARE SOLUTIONS, L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2007
Last Update Date: 12/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 CENTENARY BLVD UNIT 11
SHREVEPORT LA
71104-2469
US

IV. Provider business mailing address

2500 CENTENARY BLVD UNIT 11
SHREVEPORT LA
71104-2469
US

V. Phone/Fax

Practice location:
  • Phone: 318-221-0236
  • Fax:
Mailing address:
  • Phone: 318-221-0236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. YOLANDA FAYE BURNOM
Title or Position: PRESIDENT
Credential:
Phone: 318-221-0236