Provider Demographics
NPI:1891476834
Name:HOUSE OF RUTH LLC
Entity Type:Organization
Organization Name:HOUSE OF RUTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ONIKA
Authorized Official - Middle Name:SHAUNTE
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:EDS
Authorized Official - Phone:318-334-1140
Mailing Address - Street 1:1314 WELLERMAN RD
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-7134
Mailing Address - Country:US
Mailing Address - Phone:318-334-1140
Mailing Address - Fax:
Practice Address - Street 1:1314 WELLERMAN RD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-7134
Practice Address - Country:US
Practice Address - Phone:318-334-1140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness