LINCOLN NOVA VITAL RECOVERY CENTER,LLC; NPI #1043780851

Contact Information

LINCOLN NOVA VITAL RECOVERY CENTER,LLC

4396 HIGHWAY 80
RUSTON, LA 71270-8948

Phone: 318-251-4659
Fax: 318-251-4659
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Substance Abuse Disorder Rehabilitation Facility	324500000X
Community/Behavioral Health	251S00000X
Rehabilitation, Substance Use Disorder	261QR0405X
Rehabilitation, Substance Use Disorder Unit	276400000X

Indicates primary specialty

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NPI Profile & details for LINCOLN NOVA VITAL RECOVERY CENTER,LLC

NPI # 1043780851

LBN Legal business name LINCOLN NOVA VITAL RECOVERY CENTER,LLC

Authorized official DENNY GAMBLE - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 12/05/2018

Last updated 03/19/2025 - More than a year ago

Identifiers

Other

1336348317

251S00000X

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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