Provider Demographics
NPI:1326573973
Name:AN ENDLESS CARE SERVICE
Entity Type:Organization
Organization Name:AN ENDLESS CARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-636-0391
Mailing Address - Street 1:4111 METRO DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71109-6001
Mailing Address - Country:US
Mailing Address - Phone:318-636-0391
Mailing Address - Fax:318-635-3298
Practice Address - Street 1:4111 METRO DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71109-6001
Practice Address - Country:US
Practice Address - Phone:318-636-0391
Practice Address - Fax:318-635-3298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)