Organization
PURE, LIFE, LEGACY COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIYON GREEN (MANAGING MEMBER)
(504) 427-9305
Entity
Organization
Contact information
Practice address
7240 GENTRY RD, MARRERO, LA 70072-4576
(504) 427-9305
Mailing address
7240 GENTRY RD, MARRERO, LA 70072-4576
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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