Healthcare Provider Details

I. General information

NPI: 1831061464
Provider Name (Legal Business Name): AMAZING CARE COUNSELING AND RECOVERY AGENCY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 E CAROLINA AVE STE B
RUSTON LA
71270-3898
US

IV. Provider business mailing address

112 E CAROLINA AVE STE B
RUSTON LA
71270-3898
US

V. Phone/Fax

Practice location:
  • Phone: 318-254-3280
  • Fax:
Mailing address:
  • Phone: 318-254-3280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: JANELL NELSON
Title or Position: OWNER
Credential:
Phone: 318-254-3280