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General NPI Number Information
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NPI Number | 1972466795
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Entity Type | Organization
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Legal Business Name | HEALTH AND REJUVENATE SPA AND CLINIC, LLC
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 104 NORTHPARK DRIVE
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City | MONROE
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State | LA
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Zip | 71201
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Country | US
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Telephone | 318-355-2435
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Fax | 866-728-6481
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Provider Business Mailing Address
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Address Line | 340 SIBLEY RD
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City | CHOUDRANT
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State | LA
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Zip | 71227-3914
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Country | US
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Telephone | 318-355-2435
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Fax | 866-728-6481
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA FUTRELL
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Credential | NP
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Telephone | 318-355-2435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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