Hope Recovery Care Center | |
5260 Manhattan Rd Jackson MS 39206-4258 | |
() - | |
Not Available |
Full Name | Hope Recovery Care Center |
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Speciality | Clinic/Center |
Location | 5260 Manhattan Rd, Jackson, Mississippi |
Authorized Official Name and Position | Lorita Carol Lee (ADMIN) |
Authorized Official Contact | 6015191731 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Hope Recovery Care Center 5260 Manhattan Rd Jackson MS 39206-4258 Ph: (601) 519-1731 | Hope Recovery Care Center 5260 Manhattan Rd Jackson MS 39206-4258 Ph: () - |
NPI Number | 1558829283 |
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Provider Enumeration Date | 03/12/2019 |
Last Update Date | 03/12/2019 |
Medicare PECOS PAC ID | 7315371077 |
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Medicare Enrollment ID | O20200106001368 |
Identifier | Type | State | Issuer |
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1558829283 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Provider Name | Celevia Evans |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1619349909 PECOS PAC ID: 8325377682 Enrollment ID: I20190911002520 |
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