Healthcare Provider Details

I. General information

NPI: 1720574528
Provider Name (Legal Business Name): RESILIENT LIFE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2018
Last Update Date: 07/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6312 ARROW HEAD DR
MONROE LA
71203-3202
US

IV. Provider business mailing address

PO BOX 9021
MONROE LA
71211-9021
US

V. Phone/Fax

Practice location:
  • Phone: 318-267-9191
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: FELICIA ANTOINETTE DOWNS
Title or Position: DIRECTOR
Credential: LCSW
Phone: 318-267-9191