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311 E Cherry St Ackerman MS 39735-9795 | |
| (662) 285-6235 | |
| (662) 285-2516 |
| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 311 E Cherry St, Ackerman, Mississippi |
| Authorized Official Name and Position | Ray Shoemaker (ADMINISTRATOR) |
| Authorized Official Contact | 6622856235 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1039 Ackerman MS 39735-1039 Ph: (662) 285-6235 | 311 E Cherry St Ackerman MS 39735-9795 Ph: (662) 285-6235 |
| NPI Number | 1134272693 |
|---|---|
| Provider Enumeration Date | 01/19/2007 |
| Last Update Date | 07/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134272693 | NPI | - | NPPES |
| 02032374 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (Mississippi) | Primary |