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General NPI Number Information
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NPI Number | 1245717685
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Entity Type | Organization
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Legal Business Name | INTOUCH HEALTH
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Dates
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Enumeration Date | 07/27/2018
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Last Update Date | 05/17/2022
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Provider Practice Location Address
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Address Line | 532 MAIN ST STE A
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City | PHILADELPHIA
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State | MS
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Zip | 39350-2562
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Country | US
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Telephone | 601-781-8677
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Fax | 601-676-0550
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Provider Business Mailing Address
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Address Line | 532 MAIN ST STE A
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City | PHILADELPHIA
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State | MS
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Zip | 39350-2562
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Country | US
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Telephone | 601-781-8677
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Fax | 601-676-0550
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ERICA FLAKE
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Credential | PMHNP
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Telephone | 601-781-8677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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