NPIMap

Organization Active NPI

Allegiance Health Center of Ruston, LLC

  • Psychiatric Hospital
  • Ruston, LA
National Provider Identifier
1831283670
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
ALLEGIANCE HEALTH CENTER OF RUSTON, LLC
Practice address
1401 Ezelle St
Ruston, LA 71270-7218
Phone
(318) 255-8085
Fax
(318) 251-5146
NPI assigned
Oct 3, 2006
Last updated
Apr 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Rock Bordelon
Title
Ceo President
Phone
(318) 226-8202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

1401 Ezelle St
Ruston, LA 71270-7218

Mailing address

504 Texas St Ste 200
Shreveport, LA 71101-3526
Phone (318) 226-8202

Other identifiers 1

IdentifierTypeStateIssuer
1710831MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060308000871 LA Part A Provider - Hospital 3476560939 Practice locations: Monroe, LA; West Monroe, LA
O20180302000398 LA Part B Supplier - Clinic/Group Practice 3476560939 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Monroe, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831283670. Details of each certification follow.

Hospital certification: CCN 194087

Legal name
ALLEGIANCE HEALTH CENTER OF RUSTON, LLC
Doing business as
FREEDOM BEHAVIORAL HOSPITAL OF MONROE
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Aug 8, 2006
Last certification
Apr 28, 2021
Beds
82
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Enrollment address
4402 Sterlington Rd
Monroe, LA 71203-2338
Main/Primary Hospital Location
Hospital subgroups
Psychiatric

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Freedom Behavioral Hospital of MonroeCCN 194087 · All quality measures
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Zachary Ryder Individual Contracted Managing EmployeeMD; Jan 1, 2026
Me'Chelle Y. Allen Individual W-2 Managing EmployeeAd; Feb 1, 2026
Rock Bordelon Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2026 50%
Operational/Managerial Control Feb 27, 2006
Tara Cylyce Reed Individual Contracted Managing Employee Jan 1, 2026
Timothy Jason Reed Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2026 50%
Operational/Managerial Control Jan 1, 2020 100%
Rocknjay Investments LLC Organization, Lake Charles, LA LLC, For-profit, Chain home office, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2026 100%
Azizah Verrett Individual Contracted Managing Employee Jan 1, 2026

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1831283670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 TEXAS ST STE 200",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013526",
            "telephone_number": "318-226-8202",
            "fax_number": "318-226-8205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 EZELLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712707218",
            "telephone_number": "318-255-8085",
            "fax_number": "318-251-5146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGIANCE HEALTH CENTER OF RUSTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "BORDELON",
        "authorized_official_first_name": "ROCK",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "318-226-8202",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710831",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruston, LA

Sources for this page

Verify at the official NPI Registry.