Provider Demographics
NPI:1811276249
Name:DOBI HEALTHCARE SERVICES, LLC
Entity type:Organization
Organization Name:DOBI HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KENE
Authorized Official - Middle Name:
Authorized Official - Last Name:NWEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-670-8858
Mailing Address - Street 1:6009 FINANCIAL PLZ STE 105
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-2615
Mailing Address - Country:US
Mailing Address - Phone:318-670-8858
Mailing Address - Fax:318-670-8947
Practice Address - Street 1:6009 FINANCIAL PLZ STE 105
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129
Practice Address - Country:US
Practice Address - Phone:318-670-8858
Practice Address - Fax:318-670-8947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2160699Medicaid
LA2203783726Medicaid