OrganizationActive
Certicare,inc
NPI 1114126513 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Ruston, LA
Provider details
- NPI number
- 1114126513
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Michael Douglas, President(318) 255-1077
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
413 S Farmerville St
Ruston, LA 71270-4654
Phone: (318) 255-1077
Fax: (318) 254-8250
Approximate (ZIP-level) locationGet directions
Mailing address
413 S Farmerville St
Ruston, LA 71270-4654
Registry dates
- Enumerated
- 2007-07-16
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.