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665 S Pear Orchard Rd Ste 106-591 Ridgeland MS 39157-4861 | |
| (601) 476-5600 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 665 S Pear Orchard Rd Ste 106-591, Ridgeland, Mississippi |
| Authorized Official Name and Position | Shayla Lee (DIRECTOR) |
| Authorized Official Contact | 4806080188 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
665 S Pear Orchard Rd Ste 106-591 Ridgeland MS 39157-4861 Ph: () - | 665 S Pear Orchard Rd Ste 106-591 Ridgeland MS 39157-4861 Ph: (601) 476-5600 |
| NPI Number | 1043819717 |
|---|---|
| Provider Enumeration Date | 10/22/2020 |
| Last Update Date | 08/12/2022 |
| Certification Date | 08/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043819717 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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