Healthcare Provider Details

I. General information

NPI: 1184725533
Provider Name (Legal Business Name): NURSING HOME PSYCHOLOGICAL SERVICES OF MISSISSIPPI, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5250 GALAXIE DR SUITE A-1
JACKSON MS
39206-4311
US

IV. Provider business mailing address

PO BOX 661495
BIRMINGHAM AL
35266-1495
US

V. Phone/Fax

Practice location:
  • Phone: 256-825-4135
  • Fax: 256-825-4135
Mailing address:
  • Phone: 205-979-5882
  • Fax: 205-979-1248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: JANE E MILTON
Title or Position: PRESIDENT
Credential:
Phone: 256-825-4135