| Lincoln Nova Vital Recovery | |
|
4396 Hwy, 80 617 South Trention Ruston LA 71270 | |
| (318) 235-0503 | |
| (318) 251-4659 |
| Full Name | Lincoln Nova Vital Recovery |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 4396 Hwy, 80, Ruston, Louisiana |
| Authorized Official Name and Position | Jewel M May (ADMINISTRATOR) |
| Authorized Official Contact | 3182350503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lincoln Nova Vital Recovery 203 Brian Drive West Monroe LA 71291 Ph: (318) 235-0503 | Lincoln Nova Vital Recovery 4396 Hwy, 80 617 South Trention Ruston LA 71270 Ph: (318) 235-0503 |
| NPI Number | 1912473752 |
|---|---|
| Provider Enumeration Date | 10/19/2018 |
| Last Update Date | 10/19/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912473752 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Primary |
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