Healthcare Provider Details

I. General information

NPI: 1962333070
Provider Name (Legal Business Name): FULL CIRCLE FAMILY CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 PECANWOOD DR
NATCHEZ MS
39120-5249
US

IV. Provider business mailing address

120 PECANWOOD DR
NATCHEZ MS
39120-5249
US

V. Phone/Fax

Practice location:
  • Phone: 601-493-5120
  • Fax:
Mailing address:
  • Phone: 601-493-5120
  • Fax:

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

VIII. Authorized Official

Name: MRS. KENYATTA DAVIS
Title or Position: OWNER/ MANAGING MEMBER
Credential:
Phone: 601-493-5120