MEDICARE: ADOLESCENT BEHAVIOR CRISIS CENTER, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility
3	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1780558965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADOLESCENT BEHAVIOR CRISIS CENTER, LLC

Provider Business Mailing Address
First Line	:	2061 SILVER POINT DR
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-7753
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2061 SILVER POINT DR
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-7753
Country	:	US
Telephone Number	:	318-572-7840
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LAQUINA DOVE-CUMMINGS
Credential	:
Telephone Number	:	318-572-7840

Provider Enumeration Date	:	10/01/2025
Last Update Date	:	02/11/2026

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