| Mississippi Care, Llc | |
|
100 W Amite St Jackson MS 39201-1203 | |
| (919) 423-0267 | |
| Not Available |
| Full Name | Mississippi Care, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 W Amite St, Jackson, Mississippi |
| Authorized Official Name and Position | Myleme O Harrison (CEO) |
| Authorized Official Contact | 9194230267 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mississippi Care, Llc 6026 Six Forks Rd Raleigh NC 27609-3899 Ph: (919) 423-0267 | Mississippi Care, Llc 100 W Amite St Jackson MS 39201-1203 Ph: (919) 423-0267 |
| NPI Number | 1336647221 |
|---|---|
| Provider Enumeration Date | 01/25/2018 |
| Last Update Date | 01/25/2018 |
| Medicare PECOS PAC ID | 5092128181 |
|---|---|
| Medicare Enrollment ID | O20210111000444 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336647221 | NPI | - | NPPES |
| Provider Name | Myleme O Harrison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164477691 PECOS PAC ID: 6800977653 Enrollment ID: I20210201001860 |
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