# LIFE JOURNEY GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Life Journey Group, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922789296
- **Authorized official:** ALRICK A DEMONTEGNAC (PRESIDENT)
- **Authorized official phone:** (210) 500-6031

## Contact information

- **Practice address:** 901 E VAN BUREN AVE, MCALESTER, OK 74501-4239
- **Practice address phone:** (210) 500-6031
- **Mailing address:** 901 E VAN BUREN AVE, MCALESTER, OK 74501-4239
- **Mailing address phone:** (210) 500-6031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 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