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1001 Main St Columbus MS 39701-4751 | |
| (662) 328-9225 | |
| (662) 328-4735 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1001 Main St, Columbus, Mississippi |
| Authorized Official Name and Position | Kathy Doss (ACCTS REC/BILLING SUPERVISOR) |
| Authorized Official Contact | 6623239318 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
302 N Jackson St Starkville MS 39759-2504 Ph: (662) 323-9261 | 1001 Main St Columbus MS 39701-4751 Ph: (662) 328-9225 |
| NPI Number | 1376669135 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 07/29/2024 |
| Certification Date | 07/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376669135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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