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Organization
FAIRWAY COUNSELING
Active
Organization
FAIRWAY COUNSELING
Active
Other names
Phoenix Family Life Center
Organization subpart
No
Provider details
NPI number
Authorized official
JASMINE FURLOW (MENTAL HEALTH SPECIALIST)
(318) 992-2263
Entity
Organization
Contact information
Practice address
PO BOX 2376, JENA, LA 71342-2376
(318) 992-2263
(318) 992-2267
Mailing address
PO BOX 2376, JENA, LA 71342-2376
(318) 992-2263
(318) 992-2267
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912281031
—
LA
Enumeration date
10/23/2017
Last updated
10/23/2017
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