MEDICARE: VOLUNTEERS OF AMERICA OF NORTH LOUISIANA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1336438746
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VOLUNTEERS OF AMERICA OF NORTH LOUISIANA

Provider Business Mailing Address
First Line	:	360 JORDAN ST
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71101-4847
Country	:	US
Telephone Number	:	318-221-2669
Fax Number	:	318-221-6370

Provider Business Practice Location Address
First Line	:	520 OLIVE ST
Second Line	:	STE. A203
City	:	SHREVEPORT
State	:	LA
Zip	:	71104-2312
Country	:	US
Telephone Number	:	318-425-0618
Fax Number	:	318-429-7518

Authorized Official
Title or Position	:	PRESIDENT AND CEO
Name	:	MR. CHARLES MEEHAN
Credential	:	MSW
Telephone Number	:	318-221-2669

Provider Enumeration Date	:	04/06/2011
Last Update Date	:	02/26/2015

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