Genesis Behavioral Health Services, Llc | |
357 Towne Center Pl Ste 200 Ridgeland MS 39157-4837 | |
(769) 524-4578 | |
(769) 524-4630 |
Full Name | Genesis Behavioral Health Services, Llc |
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Speciality | Psychologist |
Location | 357 Towne Center Pl Ste 200, Ridgeland, Mississippi |
Authorized Official Name and Position | Shannon Monique Moore (MANAGER) |
Authorized Official Contact | 7695244578 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Genesis Behavioral Health Services, Llc Po Box 1956 Madison MS 39130-1956 Ph: (769) 524-4578 | Genesis Behavioral Health Services, Llc 357 Towne Center Pl Ste 200 Ridgeland MS 39157-4837 Ph: (769) 524-4578 |
NPI Number | 1265043962 |
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Provider Enumeration Date | 08/14/2020 |
Last Update Date | 08/14/2020 |
Certification Date | 08/14/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265043962 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (* (Not Available)) | Primary |
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