| |
214 Elm Avenue Mound Bayou MS 38762-5502 | |
(662) 404-8840 | |
(662) 590-7605 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 214 Elm Avenue, Mound Bayou, Mississippi |
Authorized Official Name and Position | Lorita Lynn Harris (OWNER/PRACTITIONER) |
Authorized Official Contact | 6627191202 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
1268 Memorial Dr. Cleveland MS 38732-9545 Ph: (662) 719-1202 | 214 Elm Avenue Mound Bayou MS 38762-5502 Ph: (662) 404-8840 |
NPI Number | 1558802215 |
---|---|
Provider Enumeration Date | 03/15/2017 |
Last Update Date | 02/16/2024 |
Medicare PECOS PAC ID | 5496190464 |
---|---|
Medicare Enrollment ID | O20240229001384 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558802215 | NPI | - | NPPES |
Provider Name | Lorita Lynn Harris |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1053795799 PECOS PAC ID: 0648556563 Enrollment ID: I20231220002848 |
New Horizons Wellness, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 829 W South St, Mound Bayou, MS 38762 Phone: 662-588-2481 |