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NPI 1801702295

NPI 1801702295 : APPLEGATE HEALTH SERVICES, INC. : SHREVEPORT, LA

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General NPI Number Information
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    NPI Number           |    1801702295
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    Entity Type          |    Organization 
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    Legal Business Name  |    APPLEGATE HEALTH SERVICES, INC. 
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Dates
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    Enumeration Date     |    08/24/2026
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    Last Update Date     |    08/24/2026
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Provider Practice Location Address
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    Address Line         |    6240 GREENWOOD RD BLDG 2 
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    City                 |    SHREVEPORT
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    State                |    LA
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    Zip                  |    71119-8413
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    Country              |    US
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    Telephone            |    318-562-6320
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1720 LAKEPOINTE DR STE 117 
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    City                 |    LEWISVILLE
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    State                |    TX
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    Zip                  |    75057-6425
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    Country              |    US
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    Telephone            |    214-379-3300
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    Fax                  |    
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Authorized Official
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    Title or Position    |    VP, TREASURER
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    Name                 |     BRUCE  JARVIE 
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    Credential           |    
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    Telephone            |    323-646-4138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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    Taxonomy Code        |    261QR0405X
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    Taxonomy Name        |    Substance Use Disorder Rehabilitation Clinic/Center
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    License Number       |    
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    License Number State |    
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