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Organization
LIFE JOURNEY GROUP, LLC
Active
Organization
LIFE JOURNEY GROUP, LLC
Active
Other names
Life Journey Group, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ALRICK A DEMONTEGNAC (PRESIDENT)
(210) 500-6031
Entity
Organization
Contact information
Practice address
901 E VAN BUREN AVE, MCALESTER, OK 74501-4239
(210) 500-6031
Mailing address
901 E VAN BUREN AVE, MCALESTER, OK 74501-4239
(210) 500-6031
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
NULL
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
NULL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
251B00000X
Case Management Agency
—
NULL
Other
Enumeration date
07/28/2023
Last updated
07/31/2023
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