Healthcare Provider Details

I. General information

NPI: 1861828014
Provider Name (Legal Business Name): COMPRHENSIVE NATIONAL RECOVERY SYSTEMS OF MISSISSIPPI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2013
Last Update Date: 09/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

657 W 4TH ST
HATTIESBURG MS
39401-4160
US

IV. Provider business mailing address

657 W 4TH ST
HATTIESBURG MS
39401-4160
US

V. Phone/Fax

Practice location:
  • Phone: 601-307-7944
  • Fax:
Mailing address:
  • Phone: 601-307-7944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JANETTE FAY CHRISTOPHE
Title or Position: OWNER/MANAGER
Credential: BA
Phone: 773-977-4634