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General NPI Number Information
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NPI Number | 1821381161
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Entity Type | Organization
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Legal Business Name | COMMUNITY SUPPORT PROGRAMS, INC.
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Dates
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Enumeration Date | 05/19/2011
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Last Update Date | 09/20/2011
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Provider Practice Location Address
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Address Line | 3000 KNIGHT ST STE 100
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City | SHREVEPORT
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State | LA
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Zip | 71105-2502
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Country | US
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Telephone | 318-865-1422
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Fax | 318-865-4566
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Provider Business Mailing Address
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Address Line | 3000 KNIGHT ST STE 100
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City | SHREVEPORT
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State | LA
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Zip | 71105-2502
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Country | US
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Telephone | 318-865-1422
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Fax | 318-865-4566
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MARGARET GAFFNEY SHEMWELL
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Credential | LCSW
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Telephone | 318-865-1422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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