Healthcare Provider Details
I. General information
NPI: 1609728518
Provider Name (Legal Business Name): BRIDGE TREATMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/12/2026
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
508 MINDEN ST
RUSTON LA
71270-3715
US
IV. Provider business mailing address
508 MINDEN ST
RUSTON LA
71270-3715
US
V. Phone/Fax
- Phone: 337-292-9921
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AARON
D
LAWRENCE
Title or Position: OWNER
Credential:
Phone: 337-292-9921