| Panther Creek Foundation | |
|
5750 Conger Rd Nesbit MS 38651-8898 | |
| (662) 912-5440 | |
| Not Available |
| Full Name | Panther Creek Foundation |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 5750 Conger Rd, Nesbit, Mississippi |
| Authorized Official Name and Position | Mylissa Horrocks (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9015741740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Panther Creek Foundation 2531 Shillingford Dr Memphis TN 38119-7820 Ph: (901) 574-1740 | Panther Creek Foundation 5750 Conger Rd Nesbit MS 38651-8898 Ph: (662) 912-5440 |
| NPI Number | 1558035055 |
|---|---|
| Provider Enumeration Date | 08/06/2021 |
| Last Update Date | 08/06/2021 |
| Certification Date | 08/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558035055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
Level Up Consulting Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2731 Beaver Head Dr, Nesbit, MS 38651 Phone: 901-326-0434 |