Provider Demographics
NPI:1548501448
Name:LIFE APPS FOR FAMILIES, LLC
Entity type:Organization
Organization Name:LIFE APPS FOR FAMILIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEROLYN
Authorized Official - Middle Name:FAITH
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:601-250-4505
Mailing Address - Street 1:PO BOX 2481
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39649-2481
Mailing Address - Country:US
Mailing Address - Phone:601-250-4505
Mailing Address - Fax:888-719-7816
Practice Address - Street 1:612 DELAWARE AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-4000
Practice Address - Country:US
Practice Address - Phone:601-250-4505
Practice Address - Fax:888-719-7816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-03
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA75051041C0700X
MSC30101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty