Healthcare Provider Details

I. General information

NPI: 1831708718
Provider Name (Legal Business Name): ANGELS AND BLESSINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2020
Last Update Date: 07/27/2020
Certification Date: 07/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 BROADMOOR ST
MONROE LA
71203-4124
US

IV. Provider business mailing address

1030 INABNET BLVD APT 101
MONROE LA
71203-7103
US

V. Phone/Fax

Practice location:
  • Phone: 318-614-9043
  • Fax:
Mailing address:
  • Phone: 318-614-9043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: ALICE MARIE JONES
Title or Position: ADMINISTRATOR
Credential: COUNSELOR
Phone: 318-614-9043