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General NPI Number Information
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NPI Number | 1558998799
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Entity Type | Organization
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Legal Business Name | THE CENTER OF CARE LLC
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 901 HIGHWAY 80 E
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City | CLINTON
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State | MS
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Zip | 39056-5244
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Country | US
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Telephone | 601-927-0188
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Fax | 601-292-7998
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Provider Business Mailing Address
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Address Line | PO BOX 2305
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City | CLINTON
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State | MS
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Zip | 39060-2305
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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 | EXECUTIVE DIRECTOR
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Name | MR. PHILIP MASSEY
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Credential | LCSW, CADC II
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Telephone | 601-573-5063
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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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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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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 | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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