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General NPI Number Information
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NPI Number | 1316270630
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Entity Type | Organization
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Legal Business Name | PURPOSE OF HEARTS MINISTRIES
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Dates
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Enumeration Date | 09/18/2009
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Last Update Date | 09/18/2009
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Provider Practice Location Address
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Address Line | 154 E HILL DR
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City | MADISON
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State | MS
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Zip | 39110-8962
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Country | US
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Telephone | 601-331-3085
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2932 154 EAST HILL DRIVE
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City | MADISON
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State | MS
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Zip | 39130-2932
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Country | US
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Telephone | 601-331-3085
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARY J DORSEY-REDDING
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Credential | LCSW
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Telephone | 601-331-3085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | C0533
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License Number State | MS
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