Healthcare Provider Details

I. General information

NPI: 1386789550
Provider Name (Legal Business Name): VOLUNTEERS OF AMERICA OF NORTH LOUISIANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 JORDAN ST
SHREVEPORT LA
71101-4847
US

IV. Provider business mailing address

360 JORDAN ST
SHREVEPORT LA
71101-4847
US

V. Phone/Fax

Practice location:
  • Phone: 318-221-2669
  • Fax: 318-429-7502
Mailing address:
  • Phone: 318-221-2669
  • Fax: 318-429-7502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM MULLINNIX
Title or Position: CAO
Credential:
Phone: 318-221-2669