| Reforming Lives, Llc | |
|
8044-2 Summa Avenue Suite A Baton Rouge LA 70809 | |
| (225) 903-5335 | |
| Not Available |
| Full Name | Reforming Lives, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 8044-2 Summa Avenue, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Shanda James (OWNER) |
| Authorized Official Contact | 2259035335 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reforming Lives, Llc Po Box 2349 Gonzales LA 70707-2349 Ph: (225) 903-5335 | Reforming Lives, Llc 8044-2 Summa Avenue Suite A Baton Rouge LA 70809 Ph: (225) 903-5335 |
| NPI Number | 1477072965 |
|---|---|
| Provider Enumeration Date | 09/15/2017 |
| Last Update Date | 04/30/2024 |
| Certification Date | 04/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477072965 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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