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Organization

COMMUNITY INDEPENDENT LIVING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MYRNA GOINGS (OWNER/ADMINISTRATOR)
(985) 795-0096
Entity
Organization

Contact information

Practice address
940 ELLIS ST, FRANKLINTON, LA 70438
(985) 795-0096
(985) 839-5114
Mailing address
940 ELLIS ST, FRANKLINTON, LA 70438-1728
(985) 795-0096
(985) 839-5114

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2468171
LA
Enumeration date
04/25/2018
Last updated
08/16/2021
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