MEDICARE: ADALA HEALTH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1396616223
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADALA HEALTH, LLC

Provider Business Mailing Address
First Line	:	902 S VIENNA ST
Second Line	:
City	:	RUSTON
State	:	LA
Zip	:	71270-5830
Country	:	US
Telephone Number	:	318-551-4311
Fax Number	:	318-551-4355

Provider Business Practice Location Address
First Line	:	902 S VIENNA ST
Second Line	:
City	:	RUSTON
State	:	LA
Zip	:	71270-5830
Country	:	US
Telephone Number	:	318-348-1778
Fax Number	:

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	LATOSHA J MOLLETTE
Credential	:	FNP
Telephone Number	:	318-551-4311

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	01/22/2026

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