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Organization
COMMUNITY BRIDGES SOUTH, INC.
Active
Organization
COMMUNITY BRIDGES SOUTH, INC.
Active
Other names
Campbell Street Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE L. REYNOLDS (CEO)
(318) 255-1937
Entity
Organization
Contact information
Practice address
1406 CAMPBELL STREET, RUSTON, LA 71270
(318) 255-1937
(318) 255-8233
Mailing address
PO BOX 715, RUSTON, LA 71273-0715
(318) 255-1937
(318) 255-8233
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
1035
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710431
—
LA
Enumeration date
02/27/2007
Last updated
08/22/2020
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