Whalio Doctors

NPI 1154784965

Jackson Vamc

Organisation Psychiatric Residential Treatment Facility Jackson, MS

Practice location

Address
1500 Woodrow Wilson Ave, Jackson, MS 39216-5116
Phone
(615) 355-3451
Mailing address
PO Box 94497, Cleveland, OH 44101-4497

Authorised official

Name
Erin Potter
Title
Npi Team Member
Phone
(202) 382-2579

Registered specialties

Psychiatric Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 323P00000X

Registry record

NPI
1154784965
Entity type
Organization
NPI issued
30 Mar 2016
Record last updated
4 Oct 2017

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.