NPI 1215341979

Methodist Home Road Assisted Living

Organisation Mental Illness Community Based Residential Treatment Facility Jackson, MS

Practice location

Address: 4560 Methodist Home Rd, Jackson, MS 39213-4201
Phone: (769) 257-7232
Fax: (769) 257-7745

Authorised official

Name: Kiara Lashae Johnson
Title: Manager
Phone: (601) 918-6415

Registered specialties (2)

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X

Other Community Based Residential Treatment Facility, Mental Illness providers in Mississippi →

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320900000X

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Mississippi →

Registry record

NPI: 1215341979
Entity type: Organization
NPI issued: 19 Jun 2014
Record last updated: 19 Jun 2014

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.