Healthcare Provider Details

I. General information

NPI: 1154284016
Provider Name (Legal Business Name): SHELTERED ARMS BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 W JACKSON ST
BELZONI MS
39038-3500
US

IV. Provider business mailing address

107 W JACKSON ST
BELZONI MS
39038-3500
US

V. Phone/Fax

Practice location:
  • Phone: 601-914-2915
  • Fax: 888-552-1601
Mailing address:
  • Phone: 601-914-2915
  • Fax: 888-552-1601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CARUTHIA WILLIAMS POPE
Title or Position: EXECUTIVE DIRECTOR / VP
Credential:
Phone: 601-914-2915