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9421 Eastside Drive Extention Newton MS 39345 | |
(601) 683-0279 | |
(601) 683-0264 |
Full Name | |
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Speciality | Psychiatric Unit |
Location | 9421 Eastside Drive Extention, Newton, Mississippi |
Authorized Official Name and Position | Joseph S Mcnulty (CEO) |
Authorized Official Contact | 6018496440 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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9421 Eastside Drive Extension Newton MS 39345 Ph: (601) 683-0279 | 9421 Eastside Drive Extention Newton MS 39345 Ph: (601) 683-0279 |
NPI Number | 1629143136 |
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Provider Enumeration Date | 11/21/2006 |
Last Update Date | 09/28/2010 |
Identifier | Type | State | Issuer |
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1629143136 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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273R00000X | Psychiatric Unit | 16-321 (Mississippi) | Primary |