# LIVING WATER RESIDENTIAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699516534
- **Authorized official:** LASHUNTA SHARLAN PRINGLE (ADMIN. CREDENTIALING COORDINATOR)
- **Authorized official phone:** (318) 278-5964

## Contact information

- **Practice address:** 4201 SPURGEON DR, MONROE, LA 71203-4521
- **Practice address phone:** (318) 614-7644
- **Mailing address:** PO BOX 7563, MONROE, LA 71211-7563
- **Mailing address phone:** (318) 278-5964
- **Mailing address fax:** (318) 343-7125

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 06/04/2024
- **Last updated:** 05/13/2026