Organization
LIFELINK OF LOUISIANA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA MARYLAND JACOBS (OWNER)
(318) 505-7817
Entity
Organization
Contact information
Practice address
4714 PASEO CIR, SHREVEPORT, LA 71109-6626
(318) 505-7817
Mailing address
4714 PASEO CIR, SHREVEPORT, LA 71109-6626
(318) 505-7817
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/13/2016
Last updated
04/13/2016
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