| Ruston Behavioral Health Clinic-medical | |
|
901 White St Ruston LA 71270-5960 | |
| (318) 251-4125 | |
| (318) 251-5000 |
| Full Name | Ruston Behavioral Health Clinic-medical |
|---|---|
| Speciality | Clinic/center - Primary Care |
| 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-medical 901 White St Ruston LA 71270-5960 Ph: (318) 251-4125 | Ruston Behavioral Health Clinic-medical 901 White St Ruston LA 71270-5960 Ph: (318) 251-4125 |
| NPI Number | 1356095236 |
|---|---|
| Provider Enumeration Date | 02/09/2022 |
| Last Update Date | 09/27/2023 |
| Certification Date | 09/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356095236 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| 363LF0000X | Nurse Practitioner - Family | () | Secondary |
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