Organization
GENESIS YOUTH AND FAMILY SERVICES OF LA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA JACKSON (OWNER)
(704) 253-3752
Entity
Organization
Contact information
Practice address
5700 FLORIDA BLVD, SUITE 412, BATON ROUGE, LA 70806-4274
(225) 932-0200
(225) 932-0201
Mailing address
PO BOX 42915, CHARLOTTE, NC 28215-0017
(225) 932-0200
(225) 932-0201
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
LA
Other
Enumeration date
02/28/2011
Last updated
02/28/2011
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