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Organization
EXTENSIONS OF LIFE LLC
Active
Organization
EXTENSIONS OF LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONDRA FISHER LMSW (DIRECTOR)
(504) 322-7710
Entity
Organization
Contact information
Practice address
1400 CALDER ST, GRETNA, LA 70053-5637
(504) 322-7710
(504) 322-7708
Mailing address
PO BOX 2578, GRETNA, LA 70054-2578
(504) 322-7710
(504) 322-7708
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/09/2018
Last updated
08/07/2023
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