OrganizationActive
Community Bridges South
NPI 1770619876 · Intellectual Disabilities Intermediate Care Facility · Ruston, LA
Provider details
- NPI number
- 1770619876
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Michael Reynolds, Ceo(318) 255-1937
- License
- 1010 (LA)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
1400 Benton St
Ruston, LA 71270-5404
Phone: (318) 255-1937
Fax: (318) 255-8233
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 715
Ruston, LA 71273-0715
Other names (DBA / former)
- Doing business as
- Benton Street Home
Registry dates
- Enumerated
- 2007-02-26
- 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.