Provider Demographics
NPI:1932504842
Name:RESURRECTION & NEW LIFE FELLOWSHIP
Entity Type:Organization
Organization Name:RESURRECTION & NEW LIFE FELLOWSHIP
Other - Org Name:RNLF COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL COORDINATOR/SR. PASTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:DARNELL
Authorized Official - Last Name:TENNART
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, DMIN, LPC, BCC,
Authorized Official - Phone:225-924-9164
Mailing Address - Street 1:PO BOX 45698
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70895-4698
Mailing Address - Country:US
Mailing Address - Phone:225-924-9164
Mailing Address - Fax:225-924-5479
Practice Address - Street 1:7569 E INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805-7518
Practice Address - Country:US
Practice Address - Phone:225-924-9164
Practice Address - Fax:225-924-5479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA600927792Medicaid