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General NPI Number Information
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NPI Number | 1295162972
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Entity Type | Organization
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Legal Business Name | REGION IV MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 09/26/2013
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Last Update Date | 09/26/2013
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Provider Practice Location Address
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Address Line | 120 RANDY HENDRIX DR
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City | BATESVILLE
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State | MS
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Zip | 38606-7664
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Country | US
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Telephone | 662-563-9176
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 839
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City | CORINTH
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State | MS
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Zip | 38835-0839
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CASE MANAGER
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Name | MISS KIMBERLY LANIER
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Credential |
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Telephone | 662-563-9176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | MS
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