NPI 1043780851

Lincoln Nova Vital Recovery Center,llc

Organisation Substance Abuse Rehabilitation Facility Ruston, LA

Practice location

Address: 4396 Highway 80, Ruston, LA 71270-8948
Phone: (318) 251-4659
Fax: (318) 251-4659
Mailing address: 8520 Business Park Dr, Shreveport, LA 71105-5654

Authorised official

Name: Denny E. Gamble
Title: Owner
Phone: (318) 251-4659

Registered specialties (4)

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X

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Community/Behavioral Health Agency

Agencies Taxonomy 251S00000X

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Substance Use Disorder Rehabilitation Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QR0405X

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Substance Use Disorder Rehabilitation Hospital Unit

Hospital Units Taxonomy 276400000X

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Registry record

NPI: 1043780851
Entity type: Organization
NPI issued: 5 Dec 2018
Record last updated: 19 Mar 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.