| Ava Family Services, Llc | |
|
1910 Lakeland Dr Ste C Jackson MS 39216 | |
| (601) 321-9412 | |
| (601) 321-9153 |
| Full Name | Ava Family Services, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1910 Lakeland Dr Ste C, Jackson, Mississippi |
| Authorized Official Name and Position | Dwayne Gray (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9194541672 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ava Family Services, Llc 1060 E County Line Rd Ste 3a-106 Ridgeland MS 39157-1900 Ph: (919) 454-1672 | Ava Family Services, Llc 1910 Lakeland Dr Ste C Jackson MS 39216 Ph: (601) 321-9412 |
| NPI Number | 1881102408 |
|---|---|
| Provider Enumeration Date | 01/17/2018 |
| Last Update Date | 07/09/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881102408 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Mississippi) | Primary |
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