Provider Demographics
NPI:1316091572
Name:RUSTON MENTAL HEALTH CENTER
Entity type:Organization
Organization Name:RUSTON MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN2
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:GRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:318-251-4150
Mailing Address - Street 1:316 SAINT CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71251-2344
Mailing Address - Country:US
Mailing Address - Phone:318-259-8624
Mailing Address - Fax:
Practice Address - Street 1:908 WHITE ST
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270
Practice Address - Country:US
Practice Address - Phone:318-251-4150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA137261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)