Healthcare Provider Details

I. General information

NPI: 1417107111
Provider Name (Legal Business Name): ELISHA MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 S TRENTON ST
RUSTON LA
71270-5041
US

IV. Provider business mailing address

608 S TRENTON ST
RUSTON LA
71270-5041
US

V. Phone/Fax

Practice location:
  • Phone: 318-251-1233
  • Fax: 318-254-5023
Mailing address:
  • Phone: 318-251-1233
  • Fax: 318-254-5023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberRN064413 AP03033
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MISS GLORIA DENISE MAYS
Title or Position: EXECUTIVE DIRECTOR
Credential: APMHNP-BC
Phone: 318-251-1233