| Hope For Healing Llc | |
|
929 Hwy 27 North Tylertown MS 39667 | |
| (601) 303-0154 | |
| Not Available |
| Full Name | Hope For Healing Llc |
|---|---|
| Speciality | Social Worker |
| Location | 929 Hwy 27 North, Tylertown, Mississippi |
| Authorized Official Name and Position | Lacey Holmes (OWNER/MEMBER LLC) |
| Authorized Official Contact | 6013030154 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hope For Healing Llc 18 Atley Holmes Road Jayess MS 39641 Ph: () - | Hope For Healing Llc 929 Hwy 27 North Tylertown MS 39667 Ph: (601) 303-0154 |
| NPI Number | 1982335386 |
|---|---|
| Provider Enumeration Date | 06/17/2022 |
| Last Update Date | 07/20/2023 |
| Certification Date | 07/20/2023 |
| Medicare PECOS PAC ID | 1850752619 |
|---|---|
| Medicare Enrollment ID | O20230727000211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982335386 | NPI | - | NPPES |
| 09536589 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lacey Holmes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821560319 PECOS PAC ID: 5597002188 Enrollment ID: I20190118002495 |
Walthall County Behavioral Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 125 Old State Line Rd, Tylertown, MS 39667 Phone: 601-303-0472 |