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Organization

LIVING WATER RESIDENTIAL SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LASHUNTA SHARLAN PRINGLE (ADMIN. CREDENTIALING COORDINATOR)
(318) 278-5964
Entity
Organization

Contact information

Practice address
4201 SPURGEON DR, MONROE, LA 71203-4521
(318) 614-7644
Mailing address
PO BOX 7563, MONROE, LA 71211-7563
(318) 278-5964
(318) 343-7125

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary

Other

Enumeration date
06/04/2024
Last updated
06/04/2024
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