NPI 1376840058

Mississippi Adolescent Center

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Brookhaven, MS

Practice location

Address: 760 Brookman Drive Extension, Brookhaven, MS 39601-2340
Phone: (601) 823-5700
Fax: (601) 823-5769

Authorised official

Name: Edwin C. Legrand
Title: Executive Director, Mississippi Dep
Phone: (601) 359-1288

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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

Registry record

NPI: 1376840058
Entity type: Organization
NPI issued: 16 Feb 2011
Record last updated: 16 Feb 2011

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.