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350 Capers Ave Jackson MS 39203-2131 | |
| (601) 351-8000 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 350 Capers Ave, Jackson, Mississippi |
| Authorized Official Name and Position | James G. Chastain (DIRECTOR OF HOSPITAL) |
| Authorized Official Contact | 6013518000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
350 Capers Ave Jackson MS 39203-2131 Ph: () - | 350 Capers Ave Jackson MS 39203-2131 Ph: (601) 351-8000 |
| NPI Number | 1134366867 |
|---|---|
| Provider Enumeration Date | 01/16/2009 |
| Last Update Date | 01/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134366867 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | DCS-MSH (Mississippi) | Primary |
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