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General NPI Number Information
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NPI Number | 1396178885
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Entity Type | Organization
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Legal Business Name | NORTHWEST LOUSIANA HUMAN SERVICES DISTRICT
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Dates
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Enumeration Date | 08/20/2013
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 1310 N. HEARNE AVE
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City | SHREVEPORT
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State | LA
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Zip | 71107-6516
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Country | US
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Telephone | 318-676-5111
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Fax | 318-676-5944
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Provider Business Mailing Address
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Address Line | 1310 N HEARNE AVE
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City | SHREVEPORT
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State | LA
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Zip | 71107-6516
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Country | US
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Telephone | 318-676-5643
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Fax | 318-676-5944
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Authorized Official
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Title or Position | ADMINISTRATIVE PROGRAM SPECIALIST A
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Name | MS. ROSA BATES
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Credential |
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Telephone | 318-676-5643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 2203781776
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 465
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License Number State | LA
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