Provider Demographics
NPI:1831567171
Name:FOOTPRINTS FOR LIFE YOUTH AND FAMILY SERVICES LLC
Entity type:Organization
Organization Name:FOOTPRINTS FOR LIFE YOUTH AND FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:504-223-4656
Mailing Address - Street 1:2439 DELACHAISE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-6123
Mailing Address - Country:US
Mailing Address - Phone:504-223-4656
Mailing Address - Fax:888-552-2718
Practice Address - Street 1:1040 OLD SPANISH TRL SUITE 10
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461
Practice Address - Country:US
Practice Address - Phone:504-223-4656
Practice Address - Fax:888-552-2718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health