Healthcare Provider Details

I. General information

NPI: 1114889268
Provider Name (Legal Business Name): HEART TO MIND MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 TIMBERLINE CT
RUSTON LA
71270-5276
US

IV. Provider business mailing address

PO BOX 261
QUITMAN LA
71268-0261
US

V. Phone/Fax

Practice location:
  • Phone: 318-245-5007
  • Fax: 318-228-8127
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HOLLEY IRVIN
Title or Position: RCM SPECIALIST
Credential:
Phone: 318-308-0925