Resurrection Center of Louisiana

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

RESURRECTION CENTER OF LOUISIANA

Practice address

515 E Washington St
Suite B
Shreveport, LA 71104-3658

Phone

(318) 455-7275

Fax

(318) 658-9134

NPI assigned

Jun 25, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Omisha Michelle Banks

Title

Owner

Phone

(318) 455-7275

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372118400000",
    "number": "1144660028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 E WASHINGTON ST",
            "address_2": "SUITE B",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711043658",
            "telephone_number": "318-455-7275",
            "fax_number": "318-658-9134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E WASHINGTON ST",
            "address_2": "SUITE B",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711043658",
            "telephone_number": "318-455-7275",
            "fax_number": "318-658-9134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESURRECTION CENTER OF LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-25",
        "last_updated": "2013-06-25",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "OMISHA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-455-7275",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LOUISIANA",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.