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General NPI Number Information
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NPI Number | 1003279654
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Entity Type | Organization
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Legal Business Name | RED RIVER THERAPEUTIC SOLUTIONS LLC
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Dates
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Enumeration Date | 03/31/2016
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 2715 MACKEY PL STE 135
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City | SHREVEPORT
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State | LA
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Zip | 71118-2528
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Country | US
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Telephone | 318-220-8423
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Fax | 318-220-8573
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Provider Business Mailing Address
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Address Line | 2715 MACKEY PL STE 135
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City | SHREVEPORT
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State | LA
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Zip | 71118-2528
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Country | US
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Telephone | 318-220-8423
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. TERRANCE LEE
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Credential |
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Telephone | 318-423-7963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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