| NPI | 1356095236 |
|---|---|
| Doing Business As | RUSTON BEHAVIORAL HEALTH CLINIC-MEDICAL |
| Entity Type | Organization |
| Authorized Contact | OCTAVIA GREEN Administrative Program Specialist B 318-362-3270 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2023-09-27 |