NPI 1659786887

Region IV Elderly Outpatient Psychosocial Desoto

Organisation Community/Behavioral Health Agency Southaven, MS

Practice location

Address: 915 Ferncliff Cv Suite 1a, Southaven, MS 38671-2420
Phone: (662) 449-1971
Fax: (662) 449-1974
Mailing address: PO Box 839, Corinth, MS 38835-0839

Authorised official

Name: Charlie D Spearman
Title: Executive Director
Phone: (662) 287-9883

Registered specialties

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X

Other Community/Behavioral Health providers in Mississippi →

Registry record

NPI: 1659786887
Entity type: Organization
NPI issued: 26 Jun 2014
Record last updated: 26 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.