NPI 1073679817

Copac Addiction Services

Organisation Substance Abuse Rehabilitation Facility Brandon, MS

Practice location

Address: 3949 Highway 43 N, Brandon, MS 39047-7240
Phone: (601) 829-2500
Fax: (601) 829-4278
Mailing address: 5857 Kristen Dr, Jackson, MS 39211-2831

Authorised official

Name: Wanda Newton Johnson
Title: Family Nurse Practitioner
Phone: (601) 829-2500

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X Licence R586986 (MS)

Other Substance Abuse Rehabilitation Facility providers in Mississippi →

Registry record

NPI: 1073679817
Entity type: Organization
NPI issued: 28 Dec 2006
Record last updated: 7 Mar 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.