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Organization
RUSTON SCC LLC
Active
Organization
RUSTON SCC LLC
Active
Other names
SCC of Alpine Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BEAL (CHIEF EXECUTIVE OFFICER)
(214) 252-7600
Entity
Organization
Contact information
Practice address
2401 N SERVICE RD E, RUSTON, LA 71270-2342
(318) 255-6492
(318) 255-9714
Mailing address
600 N PEARL ST STE 1050, DALLAS, TX 75201-7495
(214) 252-7600
(214) 252-7599
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1514730
—
LA
01
—
19-5538
MEDICARE PART A
LA
Enumeration date
06/17/2015
Last updated
03/04/2020
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