Provider Demographics
NPI:1326594789
Name:ALLEGIANT RESOURCES & COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:ALLEGIANT RESOURCES & COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KALA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:318-704-6041
Mailing Address - Street 1:3717 GOVERNMENT ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71302-3358
Mailing Address - Country:US
Mailing Address - Phone:318-704-6041
Mailing Address - Fax:318-704-6645
Practice Address - Street 1:3717 GOVERNMENT ST
Practice Address - Street 2:SUITE 8
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71302-3358
Practice Address - Country:US
Practice Address - Phone:318-704-6041
Practice Address - Fax:318-704-6645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-26
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5899101YP2500X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty