NPIMap

Organization Active NPI

Lincoln Nova Vital Recovery

  • Substance Abuse Rehabilitation Facility
  • Ruston, LA
National Provider Identifier
1912473752
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
LINCOLN NOVA VITAL RECOVERY
Practice address
4396 Hwy, 80
617 South Trention
Ruston, LA 71270
Phone
(318) 235-0503
Fax
(318) 251-4659
NPI assigned
Oct 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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

Authorized official

Name
Mrs. Jewel M May, MA, SACN
Title
Administrator
Phone
(318) 235-0503

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

4396 Hwy, 80
617 South Trention
Ruston, LA 71270

Mailing address

203 Brian Drive
West Monroe, LA 71291
Phone (318) 235-0503

National Provider Directory

National Provider Directory

Locations

4396 Highway 80
#617S
Ruston, LA 71270
Phone (318) 235-0503

NPI Registry JSON

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539907200000",
    "number": "1912473752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 BRIAN DRIVE",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "71291",
            "telephone_number": "318-235-0503",
            "fax_number": "318-251-4659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4396 HWY, 80",
            "address_2": "617 SOUTH TRENTION",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "71270",
            "telephone_number": "318-235-0503",
            "fax_number": "318-251-4659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN NOVA VITAL RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-19",
        "last_updated": "2018-10-19",
        "status": "A",
        "authorized_official_last_name": "MAY",
        "authorized_official_first_name": "JEWEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "318-235-0503",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, SACN"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruston, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.