Organization
L YOUNG 08 MINISTRIES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEE OTIS YOUNG LAC, CCS,CCC,CCGC (COUNSELOR)
(318) 614-2075
Entity
Organization
Contact information
Practice address
607 BEAUREGARD ST, MONROE, LA 71202-2755
(318) 600-3093
(318) 600-3093
Mailing address
1721 STANDIFER AVE, MONROE, LA 71202-5510
(318) 387-3128
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600760987
—
LA
Enumeration date
08/21/2012
Last updated
08/21/2012
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