Organization
REACHING AT POTENTIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQULINE J. NWUFOH (EXECUTIVE DIRECTOR)
(318) 512-2857
Entity
Organization
Contact information
Practice address
1651 LOUISVILLE AVE, MONROE, LA 71201-6031
(318) 654-7075
(318) 654-7075
Mailing address
1651 LOUISVILLE AVE, MONROE, LA 71201-6031
(318) 654-7075
(318) 654-7075
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
LA
Other
Enumeration date
12/21/2011
Last updated
12/21/2011
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