Provider Demographics
NPI:1427446046
Name:DAISY RESOURCES LLC
Entity type:Organization
Organization Name:DAISY RESOURCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BART
Authorized Official - Middle Name:E
Authorized Official - Last Name:LILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-439-1399
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:LA
Mailing Address - Zip Code:71268-0009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2545 HIGHWAY 4
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:LA
Practice Address - Zip Code:71251-6909
Practice Address - Country:US
Practice Address - Phone:318-439-1399
Practice Address - Fax:855-334-8166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALPC2361251S00000X
LALMFT198251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health