| Red River Therapeutic Solutions Llc | |
|
2715 Mackey Pl Ste 135 Shreveport LA 71118-2528 | |
| (318) 220-8423 | |
| (318) 220-8573 |
| Full Name | Red River Therapeutic Solutions Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2715 Mackey Pl Ste 135, Shreveport, Louisiana |
| Authorized Official Name and Position | Terrance Lee (OWNER) |
| Authorized Official Contact | 3184237963 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Red River Therapeutic Solutions Llc 2715 Mackey Pl Ste 135 Shreveport LA 71118-2528 Ph: (318) 220-8423 | Red River Therapeutic Solutions Llc 2715 Mackey Pl Ste 135 Shreveport LA 71118-2528 Ph: (318) 220-8423 |
| NPI Number | 1003279654 |
|---|---|
| Provider Enumeration Date | 03/31/2016 |
| Last Update Date | 07/26/2023 |
| Certification Date | 07/26/2023 |
| Medicare PECOS PAC ID | 0143605345 |
|---|---|
| Medicare Enrollment ID | O20220922004007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003279654 | NPI | - | NPPES |
| Provider Name | Alisha Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174773295 PECOS PAC ID: 3971995218 Enrollment ID: I20220922004032 |
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