Healthcare Provider Details

I. General information

NPI: 1174910004
Provider Name (Legal Business Name): PIVOTAL MOMENTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2015
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4790 NE EVANGELINE TRWY
CARENCRO LA
70520-5293
US

IV. Provider business mailing address

124 ABIGAYLE ROW OFC 4
SCOTT LA
70583-8909
US

V. Phone/Fax

Practice location:
  • Phone: 991-674-4050
  • Fax:
Mailing address:
  • Phone: 337-308-8125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number251S00000X
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. SCHOLAR LYNETTE JENKINS
Title or Position: CEO
Credential:
Phone: 337-308-8125