Provider Demographics
NPI:1023113651
Name:FOCUS ON FAMILY LIVING INC
Entity type:Organization
Organization Name:FOCUS ON FAMILY LIVING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CLYDE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:318-222-0991
Mailing Address - Street 1:2998 DR MARTIN LUTHER KING DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71107-4841
Mailing Address - Country:US
Mailing Address - Phone:318-222-0991
Mailing Address - Fax:318-222-0992
Practice Address - Street 1:2998 DR MARTIN LUTHER KING DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71107-4841
Practice Address - Country:US
Practice Address - Phone:318-222-0991
Practice Address - Fax:318-222-0992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3563245S0500X
343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)