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General NPI Number Information
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NPI Number | 1942735956
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Entity Type | Organization
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Legal Business Name | TRANSFORMING LIVES, INC.
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Dates
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Enumeration Date | 04/27/2017
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Last Update Date | 09/05/2018
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Provider Practice Location Address
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Address Line | 1428 PETERMAN DR STE A
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City | ALEXANDRIA
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State | LA
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Zip | 71301
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Country | US
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Telephone | 318-625-7547
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Fax |
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Provider Business Mailing Address
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Address Line | 1428 PETERMAN DR STE A
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3461
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | QUAONE ANDERS
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Credential |
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Telephone | 318-732-2577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 32402-028-0-2017
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | LA
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