| Region Iv Elderly Outpatient Psychosocial Desoto | |
|
915 Ferncliff Cv Suite 1a Southaven MS 38671-2420 | |
| (662) 449-1971 | |
| (662) 449-1974 |
| Full Name | Region Iv Elderly Outpatient Psychosocial Desoto |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 915 Ferncliff Cv, Southaven, Mississippi |
| Authorized Official Name and Position | Charlie D Spearman (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6622879883 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Region Iv Elderly Outpatient Psychosocial Desoto Po Box 839 Corinth MS 38835-0839 Ph: (662) 286-9883 | Region Iv Elderly Outpatient Psychosocial Desoto 915 Ferncliff Cv Suite 1a Southaven MS 38671-2420 Ph: (662) 449-1971 |
| NPI Number | 1659786887 |
|---|---|
| Provider Enumeration Date | 06/26/2014 |
| Last Update Date | 06/26/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659786887 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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