Provider Demographics
NPI:1083044523
Name:LIFE INVESTMENT GROUP, LLC
Entity Type:Organization
Organization Name:LIFE INVESTMENT GROUP, LLC
Other - Org Name:CALVARY COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:318-686-1954
Mailing Address - Street 1:683 HIGHWAY 615
Mailing Address - Street 2:
Mailing Address - City:SHONGALOO
Mailing Address - State:LA
Mailing Address - Zip Code:71072-2050
Mailing Address - Country:US
Mailing Address - Phone:318-423-2392
Mailing Address - Fax:
Practice Address - Street 1:105 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:HAUGHTON
Practice Address - State:LA
Practice Address - Zip Code:71037-6000
Practice Address - Country:US
Practice Address - Phone:318-423-2392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-20
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health