# GREEN CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** QUICKCARE OF RUSTON
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578021093
- **Authorized official:** CHRISTOPHER ANDING STEGALL (CFO)
- **Authorized official phone:** (318) 251-6304

## Contact information

- **Practice address:** 1809 NORTHPOINTE LN STE 102, RUSTON, LA 71270-3852
- **Practice address phone:** (318) 255-3762
- **Mailing address:** 1200 S FARMERVILLE ST, RUSTON, LA 71270-5941

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/04/2019
- **Last updated:** 03/04/2019