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NPI Code Detail

MEDICARE: TRANSFORMING LIVES, INC.

MEDICARE: TRANSFORMING LIVES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency32402-028-0-2017LA
2101YM0800XMental Health CounselorLA

General Provider Information

NPI Number : 1942735956
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRANSFORMING LIVES, INC.
Provider Business Mailing Address
First Line : 1428 PETERMAN DR STE A
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71301-3461
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1428 PETERMAN DR STE A
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71301
Country : US
Telephone Number : 318-625-7547
Fax Number :
Authorized Official
Title or Position : OFFICE MANAGER
Name : QUAONE ANDERS
Credential :
Telephone Number : 318-732-2577
Provider Enumeration Date : 04/27/2017
Last Update Date : 09/05/2018

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Directions to “TRANSFORMING LIVES, INC. ” Practice Location

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