| Southaven Services | |
|
1326 Goodman Rd E Southaven MS 38671-9542 | |
| (662) 536-3132 | |
| Not Available |
| Full Name | Southaven Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1326 Goodman Rd E, 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 |
|---|---|
| Southaven Services Po Box 839 Corinth MS 38835-0839 Ph: (662) 286-9883 | Southaven Services 1326 Goodman Rd E Southaven MS 38671-9542 Ph: (662) 536-3132 |
| NPI Number | 1003218058 |
|---|---|
| Provider Enumeration Date | 09/22/2014 |
| Last Update Date | 09/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003218058 | NPI | - | NPPES |
| 00018204 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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