Provider Demographics
NPI:1912744194
Name:JENKINS ESTATE HOLDINGS LLC
Entity type:Organization
Organization Name:JENKINS ESTATE HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SCHOLAR
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:337-308-4574
Mailing Address - Street 1:831 WALLIOR ST
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-6363
Mailing Address - Country:US
Mailing Address - Phone:337-308-4574
Mailing Address - Fax:
Practice Address - Street 1:831 WALLIOR ST
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6363
Practice Address - Country:US
Practice Address - Phone:337-308-4574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-13
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty