Lincoln Nova Vital Recovery
Substance Abuse Rehabilitation Facility in Ruston, LA. Organization (NPI-2).
NPI number1912473752
StatusActive
Last updated in NPPESOct 19, 2018
Details
- NPI
- 1912473752
- Entity type
- Organization (NPI-2)
- Legal business name
- Lincoln Nova Vital Recovery
- Organization subpart
- No
- Enumeration date
- Oct 19, 2018
- Last updated
- Oct 19, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 324500000X | Substance Abuse Rehabilitation Facility | – | – | Yes |
| 101Y00000X | Counselor | – | – |
Practice location
4396 Hwy, 80617 South Trention
Ruston, LA 71270
Phone 318-235-0503 · Fax 318-251-4659
Mailing address
203 Brian DriveWest Monroe, LA 71291
Phone 318-235-0503 · Fax 318-251-4659
Authorized official
Jewel M May
Administrator
3182350503
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