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General NPI Number Information
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NPI Number | 1568534857
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Entity Type | Organization
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Legal Business Name | COMMUNITY ENRICHMENT PROGRAMS LLC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 842 MARGARET PL
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City | SHREVEPORT
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State | LA
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Zip | 71101-4521
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Country | US
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Telephone | 318-675-0406
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Fax | 318-675-0408
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Provider Business Mailing Address
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Address Line | 2015 FAIRFIELD AVE STE 1A
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City | SHREVEPORT
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State | LA
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Zip | 71104-2066
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Country | US
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Telephone | 318-675-0406
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Fax | 318-675-0408
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Authorized Official
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Title or Position | PRESIDENT ADMINISTRATOR
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Name | TAMMY MICHELLE PLATER
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Credential |
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Telephone | 318-675-0406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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