Basic Information
Provider Information
NPI: 1093931016
EntityType: 2
ReplacementNPI:  
OrganizationName: METROPOLITAN CIRCLES, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
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Mailing Information
Address1: 3510 LINWOOD AVE
Address2:  
City: SHREVEPORT
State: LA
PostalCode: 711034512
CountryCode: US
TelephoneNumber: 3186364194
FaxNumber: 3186364196
Practice Location
Address1: 3510 LINWOOD AVE
Address2:  
City: SHREVEPORT
State: LA
PostalCode: 711034512
CountryCode: US
TelephoneNumber: 3186364194
FaxNumber: 3186364196
Other Information
ProviderEnumerationDate: 04/18/2007
LastUpdateDate: 11/17/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: THROWER
AuthorizedOfficialFirstName: JAMES
AuthorizedOfficialMiddleName: E.
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 3186364194
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix: JR.
AuthorizedOfficialCredential: LCSW
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
385HR2060X9650LAY Respite Care FacilityRespite CareRespite Care, Mental Retardation and/or Developmental Disabilities, Child

ID Information
IDTypeStateIssuerDescription
143892805LA MEDICAID


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