Healthcare Provider Details

I. General information

NPI: 1972466795
Provider Name (Legal Business Name): HEALTH AND REJUVENATE SPA AND CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 NORTHPARK DRIVE
MONROE LA
71201
US

IV. Provider business mailing address

340 SIBLEY RD
CHOUDRANT LA
71227-3914
US

V. Phone/Fax

Practice location:
  • Phone: 318-355-2435
  • Fax: 866-728-6481
Mailing address:
  • Phone: 318-355-2435
  • Fax: 866-728-6481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MELISSA FUTRELL
Title or Position: OWNER
Credential: NP
Phone: 318-355-2435