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Contact Information

BEHAVIORAL SPECIALISTS OF LA
925 OLIVE ST
SHREVEPORT, LA71104-2103
 Phone: 318-300-3560
 Fax: 318-300-3561
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Behavior Analyst

103K00000X
 

Early Intervention Provider Agency

252Y00000X
Indicates primary specialty

NPI Profile & details for BEHAVIORAL SPECIALISTS OF LA

NPI # 1801289020
LBN Legal business name BEHAVIORAL SPECIALISTS OF LA
Authorized official AMY BAMBURG - (COO/AGENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/12/2015
Last updated 02/14/2018 - About 8 years ago
Identifiers
LA Medicaid 2384066
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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