Supportive Integrated Services Incorporated

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SUPPORTIVE INTEGRATED SERVICES INCORPORATED

Practice address

842 Margaret PL
Shreveport, LA 71101-4521

Phone

(318) 675-0406

Fax

(318) 675-0408

NPI assigned

May 2, 2011

Last updated

May 2, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tammy Wright

Title

Director

Phone

(318) 675-0406

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304294400000",
    "number": "1457642985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 MARGARET PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014521",
            "telephone_number": "318-675-0406",
            "fax_number": "318-675-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 MARGARET PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014521",
            "telephone_number": "318-675-0406",
            "fax_number": "318-675-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE INTEGRATED SERVICES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-02",
        "last_updated": "2011-05-02",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "318-675-0406"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; 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.