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General NPI Number Information
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NPI Number | 1750448718
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Entity Type | Organization
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Legal Business Name | HUDSPETH REGIONAL CENTER
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | HIGHWAY 475 SOUTH
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City | WHITFIELD
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State | MS
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Zip | 39193
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Country | US
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Telephone | 601-664-6000
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Fax | 601-354-6945
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Provider Business Mailing Address
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Address Line | PO BOX 127B
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City | WHITFIELD
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State | MS
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Zip | 39193-1032
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Country | US
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Telephone | 601-664-6000
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Fax | 601-354-6945
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JOHN LIPSCOMB
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Credential | PHD
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Telephone | 601-664-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 310
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License Number State | MS
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