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CAMPBELL STREET HOME
NPI 1073649463
Intermediate Care Facility, Intellectual Disabilities in Ruston, LA

Active since February 27, 2007CLIA Certified · 4 labs
1406 CAMPBELL STREET, RUSTON, LA 71270(318) 255-1937(318) 255-8233 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Campbell Street Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CAMPBELL STREET HOME (NPI 1073649463) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Ruston, Louisiana and active in the NPI registry since February 2007. The organization holds 4 active CLIA laboratory certificates and lists Mike L. Reynolds, Ceo, as its authorized official.

NPPES Registry Identity

NPI1073649463
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameCOMMUNITY BRIDGES SOUTH, INC.
Location Address1406 CAMPBELL STREETRuston, LA 71270
Mailing AddressPo Box 715Ruston, LA 71273-0715 · (318) 255-1937 · Fax (318) 255-8233
Phone(318) 255-1937
Fax(318) 255-8233
Organization SubpartNo
Authorized OfficialMike L. ReynoldsCeo · (318) 255-1937
Enumeration DateFebruary 27, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1073649463 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
License✔ Licensed in LA · 1035
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
1406 CAMPBELL STREET, Ruston, LA 71270
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Other Names 1

Doing Business AsCampbell Street Home

Other Identifiers 1

Medicaid1710431LA

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 19D2020538

Community Bridges South Campbell Street Home · Ruston, LA
Active · expires Feb 21, 2027
CLIA Number19D2020538
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateFebruary 22, 2025
Certificate Expiration DateFebruary 21, 2027
Laboratory DirectorMichael L. Reynolds
Laboratory Phone(318) 255-0266
Laboratory LocationCommunity Bridges South Campbell Street Home1406 Campbell Street, Ruston, LA 71270
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 19D1045385

Community Bridges South Lilinda Community Residence · Ruston, LA
Active · expires Sep 13, 2027
CLIA Number19D1045385
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateSeptember 14, 2025
Certificate Expiration DateSeptember 13, 2027
Laboratory DirectorMichael L. Reynolds
Laboratory Phone(318) 255-4032
Laboratory LocationCommunity Bridges South Lilinda Community Residence2600 South Vienna, Ruston, LA 71270
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 19D1045390

Community Bridges South Benton Street Home · Ruston, LA
Active · expires Sep 13, 2027
CLIA Number19D1045390
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateSeptember 14, 2025
Certificate Expiration DateSeptember 13, 2027
Laboratory DirectorMichael Reynolds
Laboratory Phone(318) 255-5722
Laboratory LocationCommunity Bridges South Benton Street Home1400 Benton Street, Ruston, LA 71270
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 19D1058149

Community Bridges South Trace Home · Ruston, LA
Active · expires Aug 29, 2026
CLIA Number19D1058149
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateAugust 30, 2024
Certificate Expiration DateAugust 29, 2026
Laboratory DirectorMichael L. Reynolds
Laboratory Phone(318) 251-8164
Laboratory LocationCommunity Bridges South Trace Home150 Trace Drive, Ruston, LA 71270
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Community Bridges South, Inc.'s NPI number?

The NPI number for Community Bridges South, Inc. is 1073649463. It was assigned to this organization in the NPPES registry on February 27, 2007. The provider is doing business as Campbell Street Home.

Where is Community Bridges South, Inc. located?

Community Bridges South, Inc. is located at 1406 Campbell Street, Ruston, LA 71270. The listed phone number is (318) 255-1937.

What is Community Bridges South, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Does Community Bridges South, Inc. hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Community Bridges South, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.