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General NPI Number Information
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NPI Number | 1538417647
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Entity Type | Organization
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Legal Business Name | L YOUNG 08 MINISTRIES INC.
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Dates
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Enumeration Date | 08/21/2012
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Last Update Date | 08/21/2012
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Provider Practice Location Address
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Address Line | 607 BEAUREGARD ST
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City | MONROE
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State | LA
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Zip | 71202-2755
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Country | US
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Telephone | 318-600-3093
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Fax | 318-600-3093
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Provider Business Mailing Address
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Address Line | 1721 STANDIFER AVE
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City | MONROE
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State | LA
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Zip | 71202-5510
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Country | US
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Telephone | 318-387-3128
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MR. LEE OTIS YOUNG
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Credential | LAC, CCS,CCC,CCGC
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Telephone | 318-614-2075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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