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1421 E Peace St Canton MS 39046-4938 | |
| (601) 855-5323 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1421 E Peace St, Canton, Mississippi |
| Authorized Official Name and Position | Ray Shoemaker (CEO) |
| Authorized Official Contact | 6623211155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1421 E Peace St Canton MS 39046-4938 Ph: (601) 855-5323 | 1421 E Peace St Canton MS 39046-4938 Ph: (601) 855-5323 |
| NPI Number | 1578708269 |
|---|---|
| Provider Enumeration Date | 12/09/2008 |
| Last Update Date | 12/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578708269 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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