Healthcare Provider Details

I. General information

NPI: 1407800485
Provider Name (Legal Business Name): GPCH-GP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15200 COMMUNITY RD
GULFPORT MS
39503-3085
US

IV. Provider business mailing address

PO BOX 1240 15200 COMMUNITY ROAD
GULFPORT MS
39502-1240
US

V. Phone/Fax

Practice location:
  • Phone: 228-575-7000
  • Fax: 228-575-7114
Mailing address:
  • Phone: 228-575-7000
  • Fax: 228-575-7114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: REGINA RAMAZANI
Title or Position: CFO
Credential:
Phone: 228-575-7005