Healthcare Provider Details

I. General information

NPI: 1891604914
Provider Name (Legal Business Name): MSI MCKINNEY MANAGEMENT SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 GREAT FALLS CT
ROCKY MOUNT NC
27804-4646
US

IV. Provider business mailing address

28 GREAT FALLS CT
ROCKY MOUNT NC
27804-4646
US

V. Phone/Fax

Practice location:
  • Phone: 919-559-4382
  • Fax:
Mailing address:
  • Phone: 919-559-4382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: BRUSHAWN MCKINNEY
Title or Position: CEO
Credential: THD
Phone: 919-559-4382