Healthcare Provider Details

I. General information

NPI: 1083988315
Provider Name (Legal Business Name): CENTER POINT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2012
Last Update Date: 03/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6240 GREENWOOD RD
SHREVEPORT LA
71119-8413
US

IV. Provider business mailing address

135 PAUL DR
SAN RAFAEL CA
94903-2023
US

V. Phone/Fax

Practice location:
  • Phone: 318-632-2010
  • Fax: 318-632-2055
Mailing address:
  • Phone: 415-492-4444
  • Fax: 415-492-8844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number475
License Number StateLA

VIII. Authorized Official

Name: MARC JAY HERING
Title or Position: VICE PRESIDENT
Credential:
Phone: 415-526-2942