| Lincoln Nova Vital Recovery Center,llc | |
|
4396 Highway 80 Ruston LA 71270-8948 | |
| (318) 251-4659 | |
| (318) 251-4659 |
| Full Name | Lincoln Nova Vital Recovery Center,llc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 4396 Highway 80, Ruston, Louisiana |
| Authorized Official Name and Position | Denny E. Gamble (OWNER) |
| Authorized Official Contact | 3182514659 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lincoln Nova Vital Recovery Center,llc 8520 Business Park Dr Shreveport LA 71105-5654 Ph: (318) 251-4659 | Lincoln Nova Vital Recovery Center,llc 4396 Highway 80 Ruston LA 71270-8948 Ph: (318) 251-4659 |
| NPI Number | 1043780851 |
|---|---|
| Provider Enumeration Date | 12/05/2018 |
| Last Update Date | 05/21/2019 |
| Medicare PECOS PAC ID | 7416387881 |
|---|---|
| Medicare Enrollment ID | O20210825001366 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043780851 | NPI | - | NPPES |
| 1336348317 | Other | 251S00000X |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Primary |
| Provider Name | Brenda S Colbert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316003940 PECOS PAC ID: 3678472990 Enrollment ID: I20040106000578 |
Ruston Behavioral Health Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 White St, Ruston, LA 71270 Phone: 318-251-4125 Fax: 318-251-5000 | |
Masterpiece Behavior Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2100 Floyd Park Dr Ste 2, Ruston, LA 71270 Phone: 318-548-1589 | |
La Paz, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 910 S Vienna St Ste 7, Ruston, LA 71270 Phone: 318-278-0309 | |
First Step Counceling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 W Alabama Ave, Ruston, LA 71270 Phone: 318-218-2736 | |
People Centered Support Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1201 Atkins Road, Ruston, LA 71270 Phone: 318-255-9105 Fax: 318-251-9286 | |
Shreveport Mental Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 509 S Barnett Springs St, Ruston, LA 71270 Phone: 318-242-0026 |