NPI 1215165642

Grenada Lake Medical Center

Organisation Psychiatric Hospital Unit Grenada, MS

Practice location

Address: 960 Avent Dr, Grenada, MS 38901-5230
Phone: (662) 227-7000
Fax: (662) 227-7534
Mailing address: 960 Avent Dr, Grenada, MS 38901

Authorised official

Name: Charles L Denton
Title: Ceo
Phone: (662) 227-7000

Registered specialties

Psychiatric Hospital Unit Primary

Hospital Units Taxonomy 273R00000X Licence 11-245 (MS)

Other Psychiatric Unit providers in Mississippi →

Registry record

NPI: 1215165642
Entity type: Organization
NPI issued: 24 Jun 2009
Record last updated: 8 Jul 2009

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.