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1850 Chadwick Dr Jackson MS 39204-3404 | |
| (601) 376-1000 | |
| (601) 376-2821 |
| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1850 Chadwick Dr, Jackson, Mississippi |
| Authorized Official Name and Position | Paula M Lalor (DIRECTOR/DELEGATED OFFICIAL) |
| Authorized Official Contact | 6292153953 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1850 Chadwick Dr Jackson MS 39204-3404 Ph: (601) 376-1000 | 1850 Chadwick Dr Jackson MS 39204-3404 Ph: (601) 376-1000 |
| NPI Number | 1912945775 |
|---|---|
| Provider Enumeration Date | 06/03/2006 |
| Last Update Date | 04/08/2021 |
| Certification Date | 04/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912945775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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