Organization
LINCOLN NOVA VITAL RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEWEL M MAY MA, SACN (ADMINISTRATOR)
(318) 235-0503
Entity
Organization
Contact information
Practice address
4396 HWY, 80, 617 SOUTH TRENTION, RUSTON, LA 71270
(318) 235-0503
(318) 251-4659
Mailing address
203 BRIAN DRIVE, WEST MONROE, LA 71291
(318) 235-0503
(318) 251-4659
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/19/2018
Last updated
10/19/2018
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