| Ruston Behavioral Health Clinic | |
|
901 White St Ruston LA 71270-5960 | |
| (318) 251-4125 | |
| (318) 251-5000 |
| Full Name | Ruston Behavioral Health Clinic |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 901 White St, Ruston, Louisiana |
| Authorized Official Name and Position | Octavia Green (ADMINISTRATIVE PROGRAM SPECIALIST B) |
| Authorized Official Contact | 3183623270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ruston Behavioral Health Clinic 901 White St Ruston LA 71270-5960 Ph: (318) 251-4125 | Ruston Behavioral Health Clinic 901 White St Ruston LA 71270-5960 Ph: (318) 251-4125 |
| NPI Number | 1033541230 |
|---|---|
| Provider Enumeration Date | 07/30/2013 |
| Last Update Date | 03/20/2024 |
| Certification Date | 03/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033541230 | NPI | - | NPPES |
| 1710342 | Medicaid | LA | |
| 2203785977 | Other | LA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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