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General NPI Number Information
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NPI Number | 1407207863
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Entity Type | Organization
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Legal Business Name | ALLEGIANCE HEALTH CENTER OF RUSTON LLC
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Dates
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Enumeration Date | 06/28/2016
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 4402 STERLINGTON RD
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City | MONROE
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State | LA
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Zip | 71203-2338
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Country | US
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Telephone | 318-255-8085
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Fax |
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Provider Business Mailing Address
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Address Line | 4402 STERLINGTON RD
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City | MONROE
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State | LA
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Zip | 71203-2338
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Country | US
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Telephone | 318-966-4686
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DONALD E. CAMERON
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Credential |
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Telephone | 318-226-8202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 599
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License Number State | LA
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