MEDICARE: THE OXFORD CENTRE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1376701573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE OXFORD CENTRE, LLC

Provider Business Mailing Address
First Line	:	PO BOX 99
Second Line	:
City	:	ETTA
State	:	MS
Zip	:	38627-0099
Country	:	US
Telephone Number	:	662-281-1022
Fax Number	:	662-281-1024

Provider Business Practice Location Address
First Line	:	297 COUNTY ROAD 244
Second Line	:
City	:	ETTA
State	:	MS
Zip	:	38627-9523
Country	:	US
Telephone Number	:	662-281-1022
Fax Number	:	662-281-1024

Authorized Official
Title or Position	:	CEO
Name	:	THOMAS BARRETT
Credential	:	LPC
Telephone Number	:	662-281-1022

Provider Enumeration Date	:	05/26/2008
Last Update Date	:	05/26/2008

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Directions to “THE OXFORD CENTRE, LLC ” Practice Location

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