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General NPI Number Information
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NPI Number | 1639884067
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Entity Type | Organization
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Legal Business Name | AFFINITY BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 01/19/2023
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 1845 LINE AVE STE A
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City | SHREVEPORT
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State | LA
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Zip | 71101-4611
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Country | US
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Telephone | 318-670-7447
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Fax |
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Provider Business Mailing Address
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Address Line | 1845 LINE AVE STE A
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City | SHREVEPORT
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State | LA
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Zip | 71101-4611
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KEITH CUMMINGS
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Credential |
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Telephone | 318-349-8272
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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 | 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 #3
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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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