Healthcare Provider Details
I. General information
NPI: 1487762076
Provider Name (Legal Business Name): REHABILITATION CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/25/2006
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
901 FIRST AVENUE N.E.
MAGEE MS
39111
US
IV. Provider business mailing address
PO BOX 1160
MAGEE MS
39111-1160
US
V. Phone/Fax
- Phone: 662-488-8878
- Fax:
- Phone: 601-849-4221
- Fax: 601-849-7188
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 323P00000X |
| Taxonomy | Psychiatric Residential Treatment Facility |
| License Number | 685 |
| License Number State | MS |
VIII. Authorized Official
Name: MR.
CHRISTOPHER
HOWARD
Title or Position: VP & SECRETARY
Credential:
Phone: 615-861-7566