Northwest La Incs, Llc
Point of Service in Shreveport, LA(View on Map)
Legal Business Name
Northwest La Incs, Llc
NPI Number
1700901683
NPI Type
Organization
Enumeration Date
03/20/2007
Specialties
(Taxonomies)Licenses
State
Louisiana
License Number
11761
Contact
Information
Purpose
Mailing
Location
Address
4111 METRO DR
4111 METRO DR
City
Shreveport
Shreveport
State
LA
LA
Postal Code
71109-6001
71109-6001
Country
US
US
Telephone Number
(318) 636-0390
(318) 636-0390
Authorized Official
Name
Mrs. Cindy Parker
Title or Position
REGIONAL COORDINATOR
Telephone Number
(318) 636-0390
Identifiers
Identifier
1119407
Identifier State
LA
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 08/22/2020
Provider Address
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