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General NPI Number Information
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NPI Number | 1972113124
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Entity Type | Organization
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Legal Business Name | REBIRTH MENTAL HEALTH SERVICES, INC
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Dates
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Enumeration Date | 08/03/2020
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Last Update Date | 01/17/2026
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Provider Practice Location Address
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Address Line | 202 VILLAGE CIR STE 3
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City | SLIDELL
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State | LA
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Zip | 70458-5418
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Country | US
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Telephone | 985-774-4989
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Fax | 985-288-5466
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Provider Business Mailing Address
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Address Line | 202 VILLAGE CIR STE 3
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City | SLIDELL
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State | LA
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Zip | 70458-5418
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Country | US
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Telephone | 985-774-4989
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Fax | 985-288-5466
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Authorized Official
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Title or Position | PMHNP
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Name | TIFFANY FARMER VICKERS
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Credential | PMHNP
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Telephone | 985-774-4989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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