NPI: 1124067145
Provider Name: MMO OF SHREVEPORT, LLC
Former Legal Business Name: ANTARES BEHAVIORAL HEALTH, LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization
Specialization: Mental Health (Including Community Mental Health Center)
Address:
3341 YOUREE DR
SUITE 102
SHREVEPORT, LA
ZIP 71105
Phone: (318) 688-6228
Get Directions
MMO OF SHREVEPORT, LLC is a mental health (including community mental health center) clinic center in Shreveport, LA. MMO OF SHREVEPORT, LLC NPI is 1124067145. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Antares Behavioral Health, Llc.
The provider's business location address is:
3341 YOUREE DR
SUITE 102
SHREVEPORT, LA
ZIP 71105-149
Phone: (318) 688-6228
Fax: (318) 688-6466
The provider's authorized official is Robert L Miller .
The authorized official title is Ceo and has the following contact phone number (225) 293-6774.
The enumeration date for this NPI number is 6/5/2006 and was last updated on 10/3/2008.