Provider Demographics
NPI:1356116594
Name:HUMANITY2020 GROUP LLC
Entity type:Organization
Organization Name:HUMANITY2020 GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MAYQUIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-895-6106
Mailing Address - Street 1:201 CENTURY VILLAGE BLVD STE 256
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-2008
Mailing Address - Country:US
Mailing Address - Phone:318-413-5995
Mailing Address - Fax:
Practice Address - Street 1:602 MAIN ST STE 113
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-6936
Practice Address - Country:US
Practice Address - Phone:318-413-5995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty