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4305 Denny Ave Pascagoula MS 39581-5509 | |
| (228) 627-7558 | |
| (228) 762-2064 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 4305 Denny Ave, Pascagoula, Mississippi |
| Authorized Official Name and Position | Jeffrey Cooper (CEO) |
| Authorized Official Contact | 2286277558 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4305 Denny Ave Pascagoula MS 39581-5509 Ph: (228) 627-7558 | 4305 Denny Ave Pascagoula MS 39581-5509 Ph: (228) 627-7558 |
| NPI Number | 1427534221 |
|---|---|
| Provider Enumeration Date | 07/14/2018 |
| Last Update Date | 07/14/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427534221 | NPI | - | NPPES |
| 3974 | Other | ID |
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