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General NPI Number Information
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NPI Number | 1255448775
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Entity Type | Organization
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Legal Business Name | REHABILITATION CENTERS, LLC
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 03/05/2020
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Provider Practice Location Address
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Address Line | 1814 HWY 15 NORTH
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City | PONTOTOC
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State | MS
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Zip | 38863
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Country | US
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Telephone | 662-488-8878
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Fax | 662-488-8767
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Provider Business Mailing Address
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Address Line | PO BOX 619
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City | PONTOTOC
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State | MS
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Zip | 38863-0619
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Country | US
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Telephone | 662-488-8878
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Fax | 662-488-8767
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Authorized Official
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Title or Position | VP AND SECRETARY
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Name | CHRISTOPHER HOWARD
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Credential |
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Telephone | 615-861-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | 911
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License Number State | MS
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