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General NPI Number Information
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NPI Number | 1558829283
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Entity Type | Organization
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Legal Business Name | HOPE RECOVERY CARE CENTER
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Dates
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Enumeration Date | 03/12/2019
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Last Update Date | 03/12/2019
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Provider Practice Location Address
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Address Line | 5260 MANHATTAN RD
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City | JACKSON
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State | MS
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Zip | 39206-4258
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Country | US
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 5260 MANHATTAN RD
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City | JACKSON
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State | MS
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Zip | 39206-4258
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Country | US
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Telephone | 601-519-1731
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Fax | 601-982-8177
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Authorized Official
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Title or Position | ADMIN
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Name | MRS. LORITA CAROL LEE
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Credential | NURSE
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Telephone | 601-519-1731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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